Return Request

Step 1: Contact Information

First Name:

Last Name:

Organization:

Department:

Phone:

Email:

Invoice Number:

Invoice Date:
(mm/dd/yyyy)

P.O. Number:

P.O. Date:

Comments:

Step 2: Product Information

Item #1

Part Number:

Quantity:

Reason for Return: Customer ordered wrong item or quantityMain Street shipped wrong item or quantityProduct is defective (explain in comments)

Condition of Return: UnopenedOpened, with manufacturers packagingOpened, without manufacturers packaging

Requested Action: Return for credit or refundExchange for same productExchange for different product (describe in comments)

Item #2

Part Number:

Quantity:

Reason for Return: Customer ordered wrong item or quantityMain Street shipped wrong item or quantityProduct is defective (explain in comments)

Condition of Return: UnopenedOpened, with manufacturers packagingOpened, without manufacturers packaging

Requested Action: Return for credit or refundExchange for same productExchange for different product (describe in comments)

Item #3

Part Number:

Quantity:

Reason for Return: Customer ordered wrong item or quantityMain Street shipped wrong item or quantityProduct is defective (explain in comments)

Condition of Return: UnopenedOpened, with manufacturers packagingOpened, without manufacturers packaging

Requested Action: Return for credit or refundExchange for same productExchange for different product (describe in comments)