Date :
Invoice nr.
Ordernr. :
Customer name :
Contact person :
Country/City :
Name Transporter :
Contact person Coulisse :

Please fill in this form and send it back together with the goods.

Article number : Description : Q'ty : Unit : Reason of returning : Boxnr.
Remarks :

Return shipments shall only be accepted by Coulisse in consultation, in the condition received by the Customer, in the original packaging and with a statement of reasons. Return shipments shall occur at the Customer's risk. Receipt of the return shipments shall not in any event imply that Coulisse acknowledges the reason given by the Customer for the return shipments.