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 Return for Credit- please submit one form for each part number

Company :  
Account # (if known)  :  
Requester Name :  
Requester Title  :  
Phone #  :  
E-mail Address  :  
Return Information 

QTY

 :   Manufacturer :
Part # :   Lot #  : Ser # :
Original Purchase PO#  :   Purchase Date  :
R.B.Clapp Sales Order# 		 :
Are all parts like new, in original packaging, and resellable? 
Reason for return?
I have read and understand the return policy