Regal

Product Return

 
     
    Claim Type: *
   
Customer Purchase Order No. *
PURCHASE ORDER MUST BE PROVIDED TO BRANCH FOR INSPECTION TO BE PERFORMED
RESTOCKING AND/OR MODIFICATION FEES MAY APPLY FOR CREDIT RETURNS
     
  • Branch
Branch * Name of Manager *
  • Identification of Customer
Company Customer Reference Number
Contact Person * Telephone *
    Fax
Country * Email *
Suburb / City    
Address    
Post Code    
State / Province    
  • Identification of Product
Invoice No. * Purchase date (DD/MM/YYYY)
Quantity Returned *    
Part Number * Serial No.
 
  • Description of Failure or Malfunction
*