Temporary Capax Technology Return Authorisation Request Form
Company Name/ Store Name *
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Store ID
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Contact Person *
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Email Address *
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Phone Number *
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Your Return Reference
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ITEM 1 DETAILS
If there is more than one item, please repeat with a new entry but use your same reference number.
Item Code 1
Your answer
Item Name Or Description 1
Your answer
Quatity
Your answer
Fault Description 1
Your answer
Reason for Return 1
If it is STOCK ROTATION, please enter your new order number
Your answer
Condition of the item 1
Capax Invoice Number
Your answer
Invoiced Date
Your answer
ITEM 2 DETAILS
If there is more than one item, please repeat with a new entry but use your same reference number.
Item Code 2
Your answer
Item Name Or Description 2
Your answer
Quatity
Your answer
Fault Description 2
Your answer
Condition of the item 2
If it is STOCK ROTATION, please enter your new order number
Your answer
Reason for Return 2
Capax Invoice Number
Your answer
Invoiced Date
Your answer
Submit
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