Drop-Ship Item Exchange Form

Date: _________________
v091231

Instructions:
1) Contact us for an Exchange Authorization Number. We usually respond to requests within 1 working day.
2) Print and fill out the Exchange Form.
3) Pack and send the item(s) to be returned to:

Mariposahill.com
Attn: Returns
1633 Bayshore Hwy, Suite 115
Burlingame, CA 94010 ** We cannot be responsible for lost or misdelivered return shipments. Delivery confirmation and insurance is highly recommended.

Order Number (or attach packing slip):
Exchange Authorization Number: (contact us for an exchange authorization number)
Return item #	item name	size/color	price ea.	qty	total


Return Sub-total
Restocking Fee/Less 25%
Exchange item #	item name	size/color	price ea.	qty	total



Sub-total of Exchange Items
Difference in Price of Return and Exchange Items (enter 0 if exchanging for same item of different size/color)
Standard Shipping & Handling $6.95					$6.95
Total

phone:
888-876-2327
650-558-8998

Mailing address:
Mariposahill.com
1633 Bayshore Hwy Ste 115
Burlingame, CA 94010

Make sure everything is filled out completely

Payment Information

select payment type*: [ ]Visa [ ]MasterCard [ ]American Express [ ]Discover

* Sorry, no personal checks. Orders with personal checks will be returned to sender.

Credit Card Number:

Expiration Date (MM/YY): 3-4 digit verification code:

Name Printed on Card:

Signature of card holder:

Billing Address
Shipping Address
(leave blank if same as billing)

Name: Name:

Street Address: Street Address:

City: City:

State: State:

Zip: Zip:

E-mail: E-mail:

Phone Number: Phone Number:

Reason for Exchange & Other Comments