Return Request Form

Return Request Form
If you have a problem with a product or order you received from Restek (e.g., wrong part or quantity, broken or damaged item, missing items), and would like to return, exchange, or replace it, please fill out the form below to submit your request to our Returns Department.

Before Proceeding:
- Please see our returns & warranty policy for important notes and conditions that may apply to your return request.
- If you ordered from a distributor or from outside the U.S., contact your local Restek representative
- If you have a problem with a product’s function (e.g., won’t perform properly, results do not match our literature, instructions are unclear), contact Restek Technical Service or your local Restek representative
- If you have used the product, contact Restek Technical Service or your local Restek representative
Contact Information
Name*

First NameLast Name
First Name*
First Name
Last Name*
Last Name
Email*
[email protected]
Order Information
For which order are you requesting a return or an exchange? (Please provide one reference value below...)*

Order Reference

Purchase Order Number

Invoice Number

Order Number
Product Information
Have the product(s) or packaging been opened?*

YesNo
Are the products still under warranty?*

YesNo
Please see www.restek.com/warranty for more details.
Return Information
Reason for Return*

Arrived broken/damagedIncorrect item orderedIncorrect quantitySerial or lot number request errorWrong item deliveredOther
I would like to request a....*

Credit for returned item(s)Exchange for different item(s)Replacement for the same item(s)
Additional Comments
Please share any additional details here:
Upload photos or documents related to return request:

Max File Size: 10854 ; Supported File Types: pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif
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Should be Empty:

	Order Reference
Purchase Order Number
Invoice Number
Order Number

Return Request Form

Contact Information

Order Information

Product Information

Return Information

Additional Comments