Custom Pump & Controls, Inc.

with locations in Jacksonville, Tampa, and Miami, Fl.

_______________________________________

Water & Wastewater Pumping Solutions

Product Return Material Authorization (RMA) Form

Submit online form or print form & fax to: 904-858-9607.

An authorized RMA number must be issued prior to shipping any products back. Call CPC at (904) 858-9605 for a RMA number. Products received after 30 days or with unreported physical damage will be refused.  In addition, CPC reserves the right to refuse any returns that differ from the information contained on this form.  Over/under shipments must be reported within 7 days from the shipment date. Restocking charges may apply.
Date: Contact Name:
Customer Name: Phone No:
CPC Invoice#: Fax No:
CPC Sales Rep:

Return to:  CPC:  Manufacturer:  Scrap

Reason Code: Action Code:  
Customer Explanation/Comments:
Customer Signature:  Title: Date:

Product to Return

Qty

Comments

Exchange Product

Qty

Comments

 

 

 

 

 

 

Customer Return

 

 

 

Sales Pickup

 

 

 

Call Tag

Please write the RMA number on the shipping label & include a copy of this form with your return.

Custom Pump & Controls, Inc.

Attn: RMA Receiving Department

1840 River Oaks Road

Jacksonville, Fl. 32207

For CPC Internal Use

Date

Sales Rep

 

Sales Mgr

 

Approved:

 

RMA #