Return Authorization Form OF-80
Central Connecticut State University
East Hall Receiving Room
Wells Street
New Britain CT 06050-4010
Material to be shipped. Please give complete description, including serial or tag number if applicable.
This space should also be used to describe the item to be received as an exchange (including value), or amount of credit to be issued by the vendor.
CCSU Tag or Serial # __________________
Vendor’s Carrier Account # __________________
_________________________________ __________________________________ _______________
Received by (Vendor or vendor’s agent) Thomas J. Brodeur, C.P.M., Director of Purchasing Date
Rev 03/17/04 DISTRIBUTION: Original – OF-80 file 1 copy to Receiving 1 copy to Accounts Payable 1 copy to Department
FOR RECEIVING ROOM/SHIPPING USE –
Shipped Via:___________________________________ Pro. No. _______________________________________
Date Returned:_________________________________ By:___________________________________________
Vendor Name: ______________________________________
Address ________________________________________________
________________________________________________
________________________________________________
Return Authorization Number _________________
Return Authorized By ________________________
PO #
PO Date
Department
Contact
Contact phone #_________________________
SHIP TO (if different than above): __________________________
_____________________________________________________
_____________________________________________________
Return Options: Vendor Pickup Parcel Post
UPS Other (please indicate)
Insurance:
Insurance is recommended for items valued at over $1000.00.
Indicate here the value (actual or estimate) of the returned item(s) $________
Insurance is NOT needed for vendor pickup
.
[ ] Return for repair under warranty
[ ] Return for repair estimate
[ ] Return for replacement (same item) due to defect
[ ] Return for exchange (different item). Explain below.
[ ] Return for credit (no replacement). Explain below.
Note to vendor:
Repairs, replacements and exchanges should be sent to the CCSU
Receiving Room (address above) and should reference the OF-80
number in the upper right hand corner.
[ ] Receiving to pick up item(s) here -
Building _____________________
Room Number ________________
[ ] Dept will arrange to bring item(s) to the
Receiving Room
(For Purchasing Dept Use)
OF-80 Number ________
