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To initiate your credit/debit request please fill out this form completely.  Mail to: Credit Clerk, North Farm, 204 Regas Rd, Madison, WI  53714, or FAX to: 888-632-3276 (local 608-241-0688). Credit will be issued within seven business days and attached to your invoice.  WE CANNOT GIVE CREDIT ON ITEMS THAT HAVE BEEN WRITTEN ON.

FOR OFFICE USE
ONLY
Date Received:

_______________

Today's Date_________  Customer Name___________________________ Customer #____________
Address______________________________ City__________________ State_____ Zip___________
Your Name______________________________________________ Daytime Phone_______________
Invoice Number__________________  Delivery Date____________  Route/Stop___________________
How was your order placed:  (circle one)    Phone     Fax       NF-One     Mail-in     Telxon
For complete Credit Return Policy refer to "For Fast Quality Service". Credit requests must be mailed within seven days of order receipt.

ITEM
NUMBER

 ITEM DESCRIPTION
Include lot or code # if spoiled or damaged		 QTY
of product
for credit		 CASE
OR
UNIT		 TOTAL AMOUNT
of credit requested		 REASON FOR CREDIT
For reason codes 3*, 4* and 12**
see below		 OFFICE
USE
ONLY
             
             
             
             
             
             
Code   Description
  1        Billed, not received
  2        Direct Sale (alternate customer)
  3        Damaged*
  4        Spoiled/Expired*		 Code    Description
  5          Received, not billed
  6          Return, did not want***
  8          Wrong Price  (No driver adjust,
                Use Customer Credit Request)		 Code   Description
  12        Mispick**
  14        Wrong Size/Quantity
  16        Return, not ordered***
  18        Return, wrong price***

* Describe Damage & Note Package Date Code (Lot Number).
** Note Pick Label Item Number & Describe wrong product.           ***May be subject to 15% restock fee.    

                                                                                                                         Page ____ of _____

 

 
North Farm Cooperative
Mail-In Credit Request (con'd)
WE CANNOT GIVE CREDIT ON ITEMS THAT HAVE BEEN WRITTEN ON.

Today's Date__________  Customer Name______________________ Customer #______________
Address________________________________ City_________________ State_____ Zip_________
For complete Credit Return Policy refer to "For Fast Quality Service". Credit requests must be
mailed within seven days of order receipt.

ITEM
NUMBER

 ITEM DESCRIPTION
Include lot or code # if spoiled or damaged		 QTY
of product
for credit		 CASE
OR
UNIT		 TOTAL AMOUNT
of credit requested		 REASON FOR CREDIT
For reason codes 3*, 4* and 12**
see below		 OFFICE
USE
ONLY
             
             
             
             
             
             
Code   Description
  1        Billed, not received
  2        Direct Sale (alternate customer)
  3        Damaged*
  4        Spoiled/Expired*		 Code    Description
  5          Received, not billed
  6          Return, did not want***
  8          Wrong Price (No driver adjust, 
                 Use Customer Credit Request)		 Code   Description
  12       Mispick**
  14       Wrong Size/Quantity 
  16       Return, not ordered***
  18       Return, wrong price***

* Describe Damage & Note Package Date Code (Lot Number).
** Note Pick Label Item Number & Describe wrong product.                     *** May be subject to 15% restock fee.                                                                                                                                Page ____ of _____