Customer Return/Reimbursement Form
Retailer Information
*
Store Name
Customer ID:
*
Located on invoice/statement copies
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Is this a customer return?
*
Yes
No
Customer Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Date of Return
*
-
Month
-
Day
Year
Date
Reason for Return
*
Items being returned/credited:
*
If selected Reason is Other:
Please explain.
Do you need a replacement delivered?
Yes
No
Please list the SKU(s) that need a replacement:
Will the item(s) be returned to our warehouse?
Yes
No
I'm not sure
Do you have any questions, concerns, or comments regarding your request?
Please attach supporting emails, photos, etc.
Browse Files
Drag and drop files here
Choose a file
*Photos MUST be included for all damages and customer returns
Cancel
of
Signature
*
Clear
Date of Customer Inquiry:
*
-
Month
-
Day
Year
Submit
Should be Empty: