Product Return Request Form

Product Return Request Form
This form is the first step in the process and does not constitute a guarantee of refund or acceptance of return.
Customer Information
Customer Name

First NameLast Name
Mobile Number
Please enter a valid phone number.Format: 0000 000 000.
Email Address
example@example.com
Order Information
Invoice/ Quote or Sales Number (Fill one options) *
Choose one of the available order prefix options
Order Reference Number (including prefix)
Date Received

DayMonthYear
Date
Date of Purchase

DayMonthYear
Date
Product(s) Information

We don't accept returns on hygienic or custom-made products.
Item(s) Information
Reason for return:

Other
Was there a sales consultant involved?
Is the product in original packaging with attached tags/labels?
Attach picture(s) of the product and its packaging

Cancelof
Have you read our Return Policy? (https://www.activemobility.com.au/shipping-cancellation-returns-policy/)
This form cannot be submitted without reading our Return Policy. To submit this form, you must read Return Policy.
Date

DayMonthYear
Date
Signature

By signing you agree you have read our Return policy.
Please verify that you are human
Should be Empty:

Customer Information