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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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