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Parts Return Form
PLEASE NOTE:
If you are sending in a
validator or coin mech
,
you must send in the whole thing - not just the parts that are being repaired.
*
Required Fields
*
Date Returned:
/
/
mm/dd/yyyy
Account Information
Customer Number:
Order Number:
Invoice Number:
Customer Information
Business Name:
*
First Name:
Middle Initial:
*
Last Name:
*
Address Line 1:
Address Line 2:
*
City:
*
State/Province:
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Alberta
British Columbia
Manitoba
Labrador
New Brunswick
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
*
Zip/Postal:
*
Country:
Canada
U.S.A.
*
Phone:
-
-
Cell Phone/Alternate:
-
-
Business Fax:
-
-
*
Email Address:
*
Confirm Email Address:
Part Information:
Please include only parts on original order identified above.
Quantity
Part Number
Description
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
*
Check one option below:
Credit Account
Repair & Return
*
Symptom or Defect:
Machine Information
*
Extended Warranty:
Yes
No
If yes, machine serial # MUST be provided.
Serial Number:
(located on back of the machine)
ATTN: Repair Department
*
Repair and Return to Customer:
Your repaired part will be returned to you via best way.
Expedited or express return service.
Preferred Carrier:
Important: All items must be accompanied by a parts return form, and returned within 30 days. Parts must be properly packed to prevent damage. Vendnet is not responsible for items lost or damages. Vendnet is not responsible for items lost or damages. C.O.D. shipments will be refused by Vendnet!
Returning warranty part does not include refunding freight or fees. When shipping warranty parts back, please request a tracking number from your carrier (ie. UPS, US Postal, FED EX), in case it gets lost.
Comments:
A thank you page will appear after submitted and also a confirmation email will be sent.
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