Datec Fiji - Customer Refund

SECTION A Company Details
* Registered Company Name :
* Date:	Today
* Company Address :
* Business Email:
* Customer Order ( PO# / Invoice# ):
* Business Contact Number:
* Refund Request:	Full Amount Partial Amount
* Reason for Refund:
* Refund Amount:
SECTION B Bank Details
* Bank Name:
* Bank Branch:
* Bank Account Number:
SECTION C Terms and Conditions
* Attach Remittance / Receipt :
* I/we certify that the details in this form are true and correct and that I/we whose signature(s) appear below are identical to the names and person(s) mentioned above:	Yes

Customer Refund