Keeton's Return Authorization Request Form

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Product Return Authorization
Click Here for a faxable Product Return Authorization form.

Please provide as much information as possible. This will help to expedite the return process and reduce errors. Thank you.

Customer Information:

Company/Customer Name:
Account Number:
Department:
First Name:
Last Name:
Street Address:
Address (cont.):
City:
State:
Zip Code:
Contact Phone:
Contact Email (Required):

Product Information:

Original Invoice #

Manufacturer	Item number	Quantity	UM	Reason

Replace Item/s? YES NO

Replace with the following item/s:
Note: If your orders require approval, you will need to place a new order. Thank you.

Manufacturer	Item number	Quantity	UM

Comments:

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Corporate Office: 817 Manatee Ave. W Bradenton, FL, 34205, United States
Phone: 1.800.833.4735 Fax: 1.800.833.4786

Product Return Authorization

Customer Information:

Product Information:

Replace with the following item/s: Note: If your orders require approval, you will need to place a new order. Thank you.

Comments:

Replace with the following item/s:
Note: If your orders require approval, you will need to place a new order. Thank you.