LA-Z-BOY Refund Request
Please enter YOUR initials
*
Date of Request
-
Month
-
Day
Year
Date
Salesperson Initials from GERS
*
Customer Code
*
Customer Name
Phone Number
*
Street Address
*
City
State
ZIP Code
*
Customer E-mail
Reason for Refund
Please Select
Sales Ticket Void
Merchandise Return/Credit Memo
Exchange for Less Expensive Item
Miscellaneous Credit
Was this a Special or Stock Order?
*
Special
Stock
Provide Further Details Here
*
How much money is being requested?
*
Have you made comments in OCINQ?
*
Yes
No
Special Orders
**Cancelled or Returned Special Orders will require a 25% restocking fee unless the order can be cancelled with the vendor at no cost to the LA-Z-BOY Gallery**
Original Sales Ticket Number
*
Credit Memo (if applicable)
Method of Payment
How was this order originally paid for?
*
Cash/Check
Credit Card
Financing
Cash/Check
Amount Originally Paid in Cash/Check
Amount to be refunded in Cash/Check
Credit Card
Amount Originally Applied to CC
Amount to be Refunded to CC
Type of Credit Card
Please Select
Visa
MasterCard
AmEx
Other
Financing
Finance Company
Please Select
GE/Synchrony
Harrison
Tower Loan
Amount Originally Financed
Financing Code
Submit
Should be Empty: