Customer Service Request Form

Dear Felix



Date:
Customer:
Address:
City, State, Zip:
Phone:

Merchandise Problems:

Delivery Problems:


[ ] Order Not Filled [ ] Bad Address
[ ] Defective Merchandise [ ] Customer Not In
[ ] Repair Problem [ ] Delayed/Lost In Transit
[ ] Wrong Merchandise Sold [ ] Damaged In Transit
[ ] Amount Charged In Error [ ] Mdse. Missing In Pkg.
[ ] Credit/Refund Not Issued [ ] Other:

Other remarks:

Disposition:


By: ________________________________________
(name of Customer Srevice Representative)


Lydia