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RGA REQUEST FORM
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Instructions:Please fill out form completely and email to: jadie@binacompany.com
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For Office Use OnlyCompany Name:
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Requested by:
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RGA #Ship To Address:
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Date Issued: Email Address:
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QuantityProductDescriptionPO#Reason CodeCredit Code
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Return Reason CodeCredit Code
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1Wrong quantity receivedRPReplace
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2Wrong products receivedRSReturn to stock
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3Damaged in shippingCDCredit
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4Defective product RFRefund
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5Duplicate orderFor Office Use Only
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6Customer not satisfiedRS Fee?Y / N%$
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7Customer no longer needsCredit Issued?Y / NDate:
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8Other (please explain below)Credit Amount Issued:$
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OtherComments: No restocking fee or credit. South Dade was not billed for these.
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For Office Use OnlySpecial Instructions
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Date Received:
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Approved by:
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Received by:
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Inspected by:
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Comments:
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