GOODS RETURN FORM

VERSION:21-1-2011

Please Print and Complete this Form

Return it along with a copy of your invoice AFTER you have called us on (03 94087726) and received a "Goods Return Form" number

Your "Goods Return Form" Number:              ______________________________

Your original Pavtek Invoice Number:            ______________________________

Date of Goods Invoice:                                ______________________________

Your Current contact Phone Number:           ______________________________

Date Goods were shipped BACK to Pavtek: ______________________________

GOODS BEING RETURNED

QTY_____________Part Number (SKU)________________________

Reason for Return_________________________________________________________________________

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