Vendnet a Wittern Group Company
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Parts Return Form 

PLEASE NOTE: If you are sending in a validator or coin mech,
you must send in the whole thing - not just the parts that are being repaired.
*Required Fields
*Date Returned:   /  /  mm/dd/yyyy
Account Information
*Customer Number: 
Order Number: 
Invoice Number: 
Customer Information
Business Name: 
*First Name: 
Middle Initial: 
*Last Name: 
*Address Line 1: 
Address Line 2: 
*Phone:   -  - 
Cell Phone/Alternate:   -  - 
Business Fax:   -  - 
*Email Address: 
*Confirm Email Address: 
*Part Information: Please include only parts on original order identified above.
Quantity     Part Number     Description
*Check one option below:
Credit Account
Repair & Return
*Symptom or Defect:
Machine Information
*Extended Warranty:  Yes No      If yes, machine serial # MUST be provided.
Serial Number:  (located on back of the machine)
ATTN: Repair Department
*Repair and Return to Customer:  Your repaired part will be returned to you via best way.
Expedited or express return service.
Preferred Carrier: 
Important: All items must be accompanied by a parts return form, and returned within 30 days. Parts must be properly packed to prevent damage. Vendnet is not responsible for items lost or damages. Vendnet is not responsible for items lost or damages. C.O.D. shipments will be refused by Vendnet!
Returning warranty part does not include refunding freight or fees. When shipping warranty parts back, please request a tracking number from your carrier (ie. UPS, US Postal, FED EX), in case it gets lost.

Credit will be issued within 30 days, not immediately.
A thank you page will appear after submitted and also a confirmation email will be sent.
I understand the parts are to be shipped to 8040 University Blvd Clive IA 50325.

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