Weinbrenner Shoe Company, Inc. Quality begins with me DEFECTIVE RETURN AUTHORZATION REQUEST In order to expedite the processing of your RMA number, please fill out this form completely and e-mail or fax to 800-569-6817. Once your RMA request is processed, we will return your form with a Return Merchandise Authorization number via e-mail or fax. Return address at bottom of page. Please include a copy of this form with your return . Customer Information Company Name: Telephone: Shipping Address: Fax: E-mail: Contact Person: Account Number DISCONTINUED ITEMS ARE NON-RETURNABLE, UNLESS FOR DEFECT CREDIT QTY STOCK# SIZE/WIDTH INVOICE OR PURCHASE ORDER# UNIT PRICE POSSIBLE DEFECT HAS THE BOOT BEEN REPLACED Y/N TOTAL QTY: Please select one: Credit Replacement QAP 13.1 J Rev. 02 09/14/18 Page 1 of 2 RA#