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Broken / Defective / Missing / Incorrect Merchandise Form

  To ensure prompt service, please respond to all questions in the form.
*Company Name:  
*Contact Name :  
*Phone :  
*Email :  
*Invoice :  
*Action Desired :   Replace Items    Credit Account    Request Return Authorization
 
Please list broken, defective, missing or incorrect merchandise for each item.

Item 1  
Item # :       Quantity Invoiced :
Description of Issue : 
Quantity :  
 
*Was there any visible damage to the outside of the boxes? If so please detail.

*Was the packing material intact and sufficient?
*Tracking / PRO # :      
*Name of Carrier :

  Additional requests and notes. Please provide as much detail as possible.
 
Terms & Conditions

*I have read and understand the Terms & Conditions
 
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