Returned Goods Authorization
Keeping Product (Pricing Error/Discount) RGA#
Product Returned-Rework Date
Product Returned-Samples Brand
Product Returned-Mexico Dept Code
Defect Code
Reviewed with production prior to issuing credit to
Credit Amount
customer (excl. pricing errors)?
Dept Mgr Signature
CSR Initials _______ Prod Initials _______
Issued By
Distributor
o y contact upon ece p of
Notify co ac upo receipt o
Contact Person Y
Yes N
No
goods? (circle one)
Account #
Order #
Invoice # Invoice
Date
Item # Qty
Item # Qty
Reason for
Return
Root Cause
Corrective Action
WHITE - Original YELLOW - Accounting PINK - Receiving