Return Form

Return Form jens_witters 2018-08-29T06:52:04+00:00

Date
Customer name*
E-mail adress*
Contactperson
Telephone
Invoice Number
Delivery Number*
ex: VVZ18/12345
or: 123456 (6 signs for old delivery receipt)
Order Number*
Amount*
Article Code*
Reason Return application*
Description Impairment
Have you already placed a new order for this?*
- Yes
- No
Order Number*
Add another article?
- Yes
- No
Amount*
Article Code*
Reason Return application*
Discription Impairment
Have you already placed a new order for this?*
- Yes
- No
Order Number*
Add another article?
- Yes
- No
Amount*
Article Code*
Reason Return application*
Discription Impairment
Have you already placed a new order for this?*
- Yes
- No
Order number*
Attatchment
Drop files here or
Before you make a return application, carefully read our conditions.
This document document will be forwarded service@integratech.be
Name
This field is for validation purposes and should be left unchanged.

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