Company Name: _____________________________________________________________________
Contact: ___________________________ Email: __________________________________________ Phone: ___________________________________ Fax: _____________________________________ Minimum of 8 cartridges is required to be eligible for return label. Label should arrive within 15 business days upon Cartridges 4 Less receiving the label request form. Please specify on the list below the quantity, part #, and whether item is original equipment from the manufacturer (OEM) or compatible for each cartridge being sent back to ensure proper credit. Do not send any cartridges that arent specified or approved. A credit of $1.00 will be applied to your account for each empty cartridge accepted. Please allow 30 days for credit to be applied to your account. Please be sure to include your account # on this form to ensure proper credit. Please make sure your cartridges are secure within box and wrapped in protective material to avoid damage in shipping. (Newspaper, bubble wrap, etc.) Damaged items are not eligible for credit. Qty