Versa Gripps Return/Exchange Form

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Today's Date:
Exchange and Return Form
Please select One of the following options:
Exchange Item
Refund/Credit *applied to the Original Credit Card only *
Step 1 Original Order # (if available)
Estimated Order Date:
Customers Name: Billing Information
Send Exchange to: (if different from left)
Name
Name
Address
Address
Apt/Blding #
Apt/Blding #
City
State
Zip
City
COUNTRY
State
Zip
COUNTRY
Telephone:
Telephone:
Email
Email
Step 2-RETURNS In the form below please indicate the item(s) you are returning, including the reason code.
Comments: if you need more room please use the back of this paper. Thank you.
Where did you buy your item(s)?
Versagripps.com
Order #:
Amazon
Order #:
Ebay
Order #:
Reason
Quantity
Size
Style
Color
Price
Reason Codes
Total
5 -Too Small
17 - Do not like Style
7 -Too Large
11- Wrong item shipped
23. Ordered Wrong Size
Step 3 - EXCHANGES
Quantity
Size
For Fastest service, place a new order online or by phone. We'll ship your new item right away. Style
Color
Price
RETURN SHIPPING
Total
First Class FREE (1 pair) (7-10 business days) Only USA
Priority Mail $4.95 (3-4 business days) Only USA
International (shipping options emailed for your approval)
Step 4 Method of Payment If the total of your exchange or new order exceeds the value of your return, please provide a payment.
Check or Money Order enclosed
Credit Card
Credit Card Information:
Visa
Mastercard
Enclose this form along with the merchandise in a secure package. We
Card #:
recommend that you return your items via an insured and traceable carrier service. Expiration Date:
Power Gripps USA is not responsible for lost packages in transit. Original Shipping
Signature:
and return shipping costs are non-refundable. Please send your package to:
Power Gripps USA, Inc.
Attn: Returns Processing
41 Pomola Ave
Sorrento, ME 04677
Questions? Please call us at (207) 422-2051
or Email Customer Service: customerservice@versagripps.com
American Express
Discover
Security Code
We will issue a refund to the original credit card only if the merchandise is
returned in resalable condition & in the original packaging within 30 days of
purchase. After 30 days, it will be evaluated by our Returns Department to
determine if the product is defective & qualifies for merchandise credit. If the
product falls under our normal-wear policy the product will be returned to the
customer. Refunds willl take 10 days & exchanges will take 20 business days
from the date of receipt. Refer to www.versagripps.com for more information.