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.
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:*

Incorrectly orderedWrong quantityTransport damageFor inspectionWrong size/colourItem was not what I expectedWrong deliveryOther
Was there a sales consultant involved?
Is the product in original packaging with attached tags/labels?*

Yes. Item was not opened.No. Item was opened.
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/)*

Yes. I have read and agree to your Return Policy.No. I haven't read your policy.
This form cannot be submitted without reading our Return Policy. To submit this form, you must read Return Policy.
Date

DayMonthYear
Date
Signature*

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By signing you agree you have read our Return policy.
Please verify that you are human*
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Customer Information