RETURN & REFUND REQUEST FORM
Date
*
-
Month
-
Day
Year
Date
Purchase Platform
CellloBiz System
eCommerce (officialstore.celllora.com)
Shopee
LAZADA
Other
Order No.
*
Customer Name
*
Original Payment Method
*
Cash
Debit / Credit Card
Online Banking
eWallet
Other
Type of Refund
*
Product
Service
Amount of Refund (RM) (if relevant)
Reason of Refund
*
Supporting Document 1
Browse Files
Cancel
of
Supporting Document 2
Browse Files
Cancel
of
Supporting Document 3
Browse Files
Cancel
of
Leave this section blank
Approved by
First Name
Last Name
Signature
Submit
Should be Empty: