Return Merchandise Authorization

Complete this form to return merchandise to Smith-Root. This form should only be used for merchandise that is being returned for exchange or credit. Equipment that is being returned for repair should use the Equipment Repair Authorization form.

After you have submitted the completed form, you will have an opportunity to print a copy and a copy will be emailed to you at the address you supply below.

Important! Include a printed copy of the completed form in your return package. Doing so will assist in processing your return quickly.

Your Information

Name

Organization

Telephone

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Return Shipping Address

If you are exchanging merchandise, please tell us the address where you would like us to deliver the replacement merchandise.

Attention

Address

City

State/Province

Zip/Postal Code

Country

Tell Us About The Merchandise You Are Returning

Original Purchase Order Number From Your Organization (if available)

Smith-Root Order Number (if available)

Merchandise List

Please list each piece of equipment you are returning. Please include serial number where applicable.

Equipment	Serial Number

Requested Action

Please select if you would like a credit or exchange of the returned equipment.

Credit My Account

Exchange