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Customer Service Request

DATE:

CUSTOMER:

ADDRESS:

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 PACKAGE:

CREDIT/REFUND NOT ISSUED:

OTHER:

OTHER:

REMARKS:

DISPOSITION: