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ANS DISTRIBUTING - RETURN GOODS REQUEST FORM

THIS IS NOT A RETURN GOODS AUTHORIZATION - ONLY A REQUEST

IF YOU PREFER TO DOWNLOAD A PDF INSTEAD OF USING THIS FORM, GET THE PDF HERE
Fields marked with a Red * and Bold are required.
* Company Name: 
* Requested By: 
* Address Line 1: 
Address Line 2: 
* City: 
    * State:      * Zip: 
* Phone Number: 
    Fax: 
* Email Address: 
* Warehouse: 

INSTRUCTIONS
  1. COMPLETELY FILL OUT ALL SECTIONS PERTAINING TO YOUR RETURN.
  2. SUBMIT THIS FORM (LOOK FOR THE SUBMIT BUTTON AT BOTTOM)
  3. OR DOWNLOAD THIS PDF VERSION AND FAX OR EMAIL THIS RETURN REQUEST FORM TO CHRIS PIPPIN AS NOTED BELOW.
  4. A NUMBERED RETURNED GOODS AUTHORIZATION WILL BE ISSUED AND FAXED OR EMAILED TO YOU.
RETURN CODE
REASON FOR MATERIAL RETURN
A
 WARRANTY RETURN FOR REPLACEMENT- MUST INCLUDE MFG WARR. PAPERWORK OR TAGS AS NEEDED.***
B
 CORE RETURN FOR EXCHANGE CREDIT- NOT UNDER WARRANTY*
C
 CORE RETURN TO BE PLACED IN CORE BANK - CUSTOMER RESPONSISBLE FOR UPS RETURN CHARGES*
E
 PARTS ORDERED IN ERROR - RESTOCKING FEE AND RETURN FREIGHT MAY APPLY**
F
 EXCESS STOCK PARTS RETURN - RESTOCKING FEE AND RETURN FREIGHT MAY APPLY**
G
 PARTS SHIPPED AND RECEIVED IN ERROR**
* CORE CREDIT EXCHANGE MUST TAKE PLACE WITHIN 60 DAYS OF ORIGINAL PURCHASE
** ORIGINAL INVOICE REQUIRED TO ENSURE PROPER CREDIT
*** WARRANTY NOZZLES MUST HAVE SERIAL NUMBERS OR DATE CODES NOTED.

LINE
RETURN CODE
QUANTITY
PART NUMBER
DESCRIPTION
SERIAL NUMBER OR DATE CODE
ORIGINAL INVOICE
1
2
3
4
5
6

Description of warranty issue or failure / Other comments:

SHIPPING ADDRESS FOR REPLACEMENTS (IF APPLICABLE)
Company Name: 
Address Line 1: 
Address Line 2: 
City: 
    State:     Zip: 

            

If you have any questions or comments regarding this form, please contact Chris Pippin by Phone: 800-334-6249 or Fax: 602-278-6678 or email at chrisp@ansdistributing.com
 
 
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