Return For Credit Order Form

Return for Credit
automotive service centres
ORDER FORM
Please complete:
Store name:
Store address:
Store phone number:
Store contact:
Payment details
EFT
Credit Card
(Invoice will be emailed to you
before dispatch of goods)
Visa Card
MasterCard
Card Number:
Expiry date:
Name on card:
CCV:
RETURN FOR CREDIT
STORE NAME:
Reference NO:
Date:
Supplier:
Address:
P/C:
State:
Item
Supplier Inv.
Part No.
Driver Signature:
Description
Qty
Unit Cost
Total Cost
1
2
3
4
5
6
7
8
Sub Total
Reason for return:
GST
Total Value
These goods were returned from the store at:
WHITE: Supplier copy to be sent with goods
Raised by:
YELLOW: To be sent to accounts department
PINK: Shop copy
Item Number
Description
Qty
Price
ABSPS006
A5 triplicate book, 50 sets per book, croc board cover.
12
$79.20
Order Total
$
ORDER FORM TERMS & CONDITIONS
1. Pricing includes GST and is effective from 15th March 2015. Pricing does not include delivery costs and is subject to change without notice.
2. Delivery costs will be calculated and advised to you prior to dispatch of goods.
4. This order form is effective from 15th March 2015 and is to be completed in conjunction with the ABS online ordering site http://absonline.dpma.com.au
5. Full details of products can be found on the ABS Online Ordering site - http://absonline.dpma.com.au
6. If using this order form, please fax order to DPMA (07) 3205 2523 or email to [email protected].
7. Please contact DPMA on (07) 3205 2525 if you have any queries.
Make it easy,order online.
absonline.dpma.com.au