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REQUEST A RETURN
Company Details
*
Indicates required field
Company Name
*
Your PO Reference
*
Name
*
First
Last
Company Address
*
Line 1
Line 2
City
State
Zip Code
Country
Position
*
Email
*
Decription of goods being returned
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Manufacturer Part #
*
Quantity
*
Serial Number
*
Full details of fault/reason for return
*
INSIGNIA IT - Stand out Service Everytime
Our Sales Order Reference
*
Invoice Reference
*
Date of purchase
*
Please specify date in DD/MM/YYYY format
Reason for return
*
Wrong Item Supplied
Parts Missing
Damaged on Arrival
Faulty
Customer Error
Other
Please select the reason for return. If "Other", please clearly detail the reason for return in the corresponding box
Reason for return (If Other)
*
Action Required
*
Credit Note/Refund
Replacement
Please specify whether your require a return for credit/refund or a replacement
Collection Address (if different)
*
Line 1
Line 2
City
State
Zip Code
Country
Number of boxes to collect
*
Please confirm tital number of boxes to collect
Please click
HERE
to review our terms and conditions
Please tick the following box where prompted to confirm that you hereby agree to the INSIGNIA IT terms of sale, and in particular, our terms pertaining to our "Returns Policy" (clause 5). You must be an authorised signatory and confirm that the details provided in the form are accurate and complete. Submission of this online form constitutes applying an electronic signature.
Acceptance of INSIGNIA IT's "Return's Policy"
*
I accept the INSIGNIA IT "Terms of return within clause 5 of the terms of sale"
Please tick the box to confirm your acceptance of the INSIGNIA IT "Terms of sale" and in particular, clause 5 of these terms
For and behalf of (insert company name)
*
Print Name
*
First
Last
Submit Request for Return
