Return Goods Form

RETURN GOODS FORM:

Date:*
Requested By:*
Company Name:*
Address 1:*
Address 2:
City:*
State/Province:*
ZIP/Postal Code:*
Country:*
Phone Number:*
Fax Number:*
E-mail Address:*
R&M Order Number:*
Customer P.O. Number:
Model No. / Serial No.:*
1. Quantity:*	Part Number:*	Reason for Return Request (be specific):*
2. Quantity:	Part Number:	Reason for Return Request (be specific):
3. Quantity:	Part Number:	Reason for Return Request (be specific):
4. Quantity:	Part Number:	Reason for Return Request (be specific):
5. Quantity:	Part Number:	Reason for Return Request (be specific):

	Note: RGA number will be faxed to you upon processing the claim. Acceptance of returned goods authorization and restock fee is at R&M's discretion. Please refer to Section 3 of our Standard Terms & Condition of Sale (revision 101707), which is available at www.rmhoist.com. Please include the RGA number on the outside of the package(s) being returned. Customer is responsible for return packaging and freight costs. SHIPPER IS RESPONSIBLE FOR RETURN PACKAGING.
	* denotes required field
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