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Hatchik Supply Company
Return Form
Company/Account # : ________________________________
___Defective ___ Not Defective
Item # : ____________________________
Date of Return: _____/_____/_____
Date of Purchase: _____/_____/_____
Original Sales Order/Invoice # : ____________________
Why is the item being returned? (please be specific):
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
Was it installed? : ____ Yes ____ No
If Part is from a Heater:
Model # of Heater: _____________________________
Serial # of Heater: ______________________________
When was it Installed : _____/_____/_____
How long after installation did the part fail: _________________
For Counter Use Only
Date Received: _____/_____/_____ Replacement: ____Yes ___No
Received By: __________________ S/O #: ________________________
Remarks: ___________________________________________________________
___________________________________________________________________
For Office Use Only
RGA # : __________________________ Notes: ______________________
____________________________
____________________________
____________________________
Remarks: _____________________________________________________________________________________
_____________________________________________________________________________________ ______________________________________________
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