RGA Request Form

J.H. Larson Company

Request for Return Goods Authorization

Date:

Customer Name:

Customer Account Number: Customer PO Number:

Contact Person: Telephone Number:

Return Codes:
1. Damage/Defective (details required) 3. Shipped in error	2. Ordered In Error 4. Other (details required)

Qty

Invoice Nbr

Catalog Nbr

Code and Reason for Return

Click here to Print the form and then fax it to the JHL Branch you purchased the material from:
1. All material must be in resaleable condition and a current stocking item. 2. Credit Invoice will be issued pending final inspection, review and acceptance. 3. Material returned over 90 days from purchase are subject to a restocking fee. 4. Non-stock items are subject to prior authorization and terms from the factory.