RETURN and EXCHANGE FORM Please complete this form and enclose with returned or exchanged product. Products returned with incomplete information may not be processed properly. A return UPS label is included with your order. If you did not receive one, please call 1-877-566-7547 for a replacement. Please write down the UPS Tracking Number (found on the label) for your records. CONTACT INFORMATION SALES ORDER #___________ PURCHASE DATE __________ EMPLOYEE NAME_______________________________________EMPLOYEE ID (for payroll deduction) ____________ COMPANY _________________________________________ UNIT Number ______________________ STORE ADDRESS _________________________________ CITY __________________STATE _____ ZIP ________ WORK PHONE (____) _____-_______ HOME PHONE (____) _____-_______ CELL PHONE (____) _____-_______ EMAIL _________________________________________ SHOE STYLE RETURNED_________________ SIZE ___________ SELECT ONE: RETURN for REFUND WIDTH________ EXCHANGE EXCHANGE SHOE FOR: SHOES PURCHASED BY: Company payroll deduction Credit Card Check/MO STYLE #________________ SIZE _____ WIDTH ______ (*Shipping and Handling charges not refunded, prepaid shipping label provided) REASON FOR RETURN If the exchange shoe is of the same style [only size change] then it will be considered an even exchange. If shoes are exchanged for a different style, a refund will be issued and a new order created. If a credit card was used for payment, the customer will be contacted for new payment information. Too Small Style Too Large Comfort Incorrect Width Defective Other _____________________ INFORMACION DE CONTACTO NOMBRE DE EMPLEADO_________________________________NUMERO DE EMPLEADO _____________________ COMPANIA _________________________________________ UNIDAD _________________ DIRECCION DE LA COMPANIA ________________ CIUDAD ___________ESTADO____CODIGO POSTAL _______ TELEFONO DEL TRABAJO (____) _____-_______ TELEFONO CELULAR (____) _____-_______ EMAIL_________________________________________ SELECCIONE UNO: CAMBIE POR OTRO TAMAÑO/MODELO PRODUCTO QUE SE VA REGRESAR: MODELO#________ TAMANO___ ANCHO___ ZAPATOS COMPRADOS POR: Deduccion de cheque Tarjeta de Credito Cheque/G.P. Fecha de compra __________ Factura#_________ RAZON DE LA VUELTA – POR FAVOR MARQUE UNA O MAS Muy pequeño Estilo Muy Grande Comodidad Incorrecto ancho Defectuoso Otro_____________________ REGRESAR PARA REEMBOLSO PRODUCTO A CAMBIAR: MODELO #__________TAMANO____ ANCHO ________ (Shoes can only be exchanged for product of equal or lesser value. If a higher priced product is selected, a refund will be issued.) CAMBIO PARA: MODELO #___________ TAMANO____ ANCHO_______ Questions? Contact us at 877-566-7547 or [email protected]