Return Authorization Form

Consignment Inventory Item:(Required)
Quantity Product Empty Lot # Labeled Actions
Quantity Product Empty Lot # Labeled Actions
Product Lot # Lbs Actions

*All containers either empty, partial, or full must be properly labeled and all caps and bungs in place and secured.
*If container is not labeled or contains product that has not been declared before pick up it will not be loaded.
Polymer, PerManganate, HFS containers cannot be reused. Those containers will be charged a disposal fee.

Disposition of Returned Product:(Required)
This field is for validation purposes and should be left unchanged.