Weinbrenner Shoe Company, Inc.Quality begins with me

RESTOCKABLE (NEW) RETURN AUTHORZATION REQUEST

In order to expedite the processing of your RMA number, please fill out this form completely and e-mail or fax to 800-569-6817. Once your RMA request is processed, we will return your form with a Return Merchandise Authorization number via e-mail or fax. Return address at bottom of page. Please include a copy of this form with your return.

Customer Information

Company Name: Telephone:Shipping Address: Fax:

E-mail:Contact Person: Account Number

DISCONTINUED ITEMS ARE NON-RETURNABLE

QTY STOCK# SIZE/WIDTH

INVOICE OR PURCHASE ORDER#

UNIT PRICE RETURN REASON

TOTAL QTY:

Please select one: Credit Replacement

PH: 800-826-0002 FAX: 800-569-6817

Send footwear to: Weinbrenner Shoe, Returns Department, 108 S Polk St, Merrill, WI 54452

QAP 13.1 J Rev. 02 09/14/18 Page 1 of 1

RA#