Customer Returns Form

Returned goods are for:(Required)

Customer's Name(Required)

First Last

Contact Person Name

First Last

Customer Reference Number

Purchase Order Number

Date(Required)

Email(Required)

Phone(Required)

Delivery Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Product Details (Please list the following information: The item number/product code for each product, the description of the product as well as the quantity of each product.)

Date of Purchase

Invoice numbers

Description of fault/s(Required)

Other details/comments

Customer Returns Form

Customer Returns Form

Return Goods to: ActivTec Solutions. 379 Thynne Road. Morningside QLD 4170.

IMPORTANT: Inspection charges may apply for items returned where there is no fault found or the repair is not approved.