Performance Industry
RETURN & EXCHANGE FORM
Please note: All exchanges relating to size / colour / print incur a $5 freight charge ($7 rural delivery). Please enclose this with your exchange.
DATE OF RETURN:
Name:
Address:
Town/City: Postcode:
Phone (day/night)
Email:
PLEASE CIRCLE ONE OF THE FOLLOWING OPTIONS:
1.Exchange for other item(s) 2.Reimburse via my original method of payment
STEP 2 - ITEM(S) RETURNED
Please list the item(s) you are returning and specify reason as appropriate.
ITEM 1: ITEM 2:
Colour: Colour:
Size: Size:
Print: Print:
Reason: Reason:
Total $
STEP 3 – EXCHANGE(S) REQUIRED (if appropriate)
Item Type Item Type:
Colour: Colour:
Size: Size:
Print: Print:
Total $
STEP 4 – RECONCILIATION
Refund (from step 2): $
Exchange/Purchase (from step 3): $
Balance to pay/refund due: $
Freight charge: $ 5.00
Total $
Method of payment (please circle): Cheque enclosed /Visa / Mastercard / Amex
Credit Card number: Expiry date:
Cardholder’s name: Signature:
Please Return to:
Performance Industry 2010 Limited
16 Erskine Street
Queenstown 9304