Financial & Business Services » Merchandise Return Form

* PO number or credit card reference:

* Contact First Name:

* Contact Last Name:

* Phone:

* Email:

* Department:

Chartfield:

* Reason for return?

* Pick up location:

Number of boxes:

Hand truck needed?

Yes
No

* Ship to Name:

* Ship to Street Address:

* Ship to City:

State:

* Ship to Zip:

* Hazardous Material?

Yes
No

* Quantity:

* Catalogue/Part number:

* Description:

Please check one:

I have contacted the vendor and obtained all pertinent information (including RA# if applicable). The box is labeled and ready to ship.
Please help me setup this return. (Please fill in the remainder of this form as best you can)

Vendor Phone:

How do you want these items returned? UPS, Best way:

Do you want this return insured?

Yes
No

If yes, please specify a $ amount:

Shipping charges paid by:

Vendor
Call Tag
Department