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Order Cancellation Form


Our Policy

For goods stocked by your distributor, an Order Cancellation Form will be accepted if your distributor has not shipped the order. In the event that your order has already left their warehouse, please refer to our Returned Goods Form.

The client is responsible for all PayPal administrative charges incurred when products are purchased via PayPal and canceled thereafter.  These charges are a direct result of PayPal's policies.  A Credit will be issued to the client, minus all PayPal administrative charges, including an additional $25 distributor administration processing fee.

All Order Cancellations are pending until your distributor confirms and provides a Cancellation Authorization Number which will detail all applicable fees.  This response may take up to thirty (30) business days.

Failure to comply fully with these requirements will result in the manufacturer or distributor not assuming any liability whatsoever for cancellation of an order.  Customers shall remain liable for payment in full.

Click here to download an Order Cancellation pdf document which can be faxed.


Please complete the form below in its entirety and Submit.

 

Date and Time of Purchase

               

Full Name of Distributor

               

 

Billing Information

             

Complete Legal Company Name

               

Current Street or P.O. Box Address

               

City

               

Province/State

               

Postal Code/Zip Code

               

Country

               

 

Shipping Information

             

Complete Legal Company Name

               

Current Street Address

               

City

               

Province/State

               

Postal Code/Zip Code

               

Country

               

 

Contact Information

             

Contact's First and Last Name

               

Phone Number including Area Code and Extension

               

Contact's email

               

Fax Number including Area Code

               

 

Order Information

             

Method of Payment

               

Invoice Number (if applicable)

               

Purchase Order

               

 

Product Code            Qty     Description

             

  

                 

Reason for Cancellation

             

 

                 

 

Product Code            Qty     Description

             

  

                 

Reason for Cancellation

             

 

                 

 

Product Code            Qty     Description

             

  

                 

Reason for Cancellation

             

 

                 

 

Product Code            Qty     Description

             

  

                 

Reason for Cancellation

             

 

                 

 

Product Code            Qty     Description

             

  

                 

Reason for Cancellation

             

 

                 

 

               

 


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