IPD - Return Merchandise Authorization

Return Merchandise Authorization
(Invoice or Packing List and RMA numbers must be included with return)

General Policies:
All returns must include copies of the original packing list or invoice.
All returns are subject to the terms and conditions of IPD's return policy. (Copies available upon request).
All returns are to be sent freight pre-paid. (If returned collect the shipment may, at IPD's option, be refused or freight amount deducted from credit).
IPD claims no obligation to credit obsolete products or part numbers.
Opened Gasket sets are non-returnable.
Return authorization numbers do not guarantee credit of merchandise
RMA numbers expire 30 days from approval date.

Complete the form below and submit to IPD for review. When approved you will be contacted with the RMA number and instructions on how your return will be processed (For quality assurance purposes IPD will inform you upon assignment of the RMA number where merchandise is to be shipped.)
---------------------------------------------------------------------------------------------------------------------------------
** Fields are Mandatory

Company Name : *

Account #*

Phone :*

Fax : *

City : *

State : *

Country:*

Zip Code: *

Contact Name:*

Email : *

Invoice or
Packing list # *

Date of Purchase: *

(dd/mm/yyyy)

Purchase from which IPD location? *

	Torrance (Corporate)	Houston	Australia
	Cleveland	Portland	Denmark

Reason for return?*

--------------------------------------------------------------------------------------------------------------------------

Qty*	Part Number*	Description	Price *	Comments or Notes	Action
Qty*	Part Number*	Description	Price *	Comments or Notes










	Approx.value of return: