Historical Backsale Request Form

**Please Be Advised**

Historical Tickets CANNOT Be Deleted Once It Is Used or Modified on The Sales Side.

This Form Has The Ability To Submit Up To (3) Units. If You Only Need To Submit (1) or (2) Units You Have The Ability To Proceed To The End To Submit.

- Step 1 of 4

Requester Name: *

Location:

Operations E-mail: *

Requester Email: *

Unit 1:

Customer Name:

Current Customer Full Address:

Address Line 1

Address Line 2

City

State

Zip Code

Current Customer Phone Number:

RMS Service Ticket (If Applicable):

Store Number Where Customer Will Reselect:

City Where Customer Will Reselect:

Brief Reason For Reselection: (i.e. - Store Authorized Courtesy Exchange, RGA Approved, etc.)

ALI For Each Unit:

Style and Cover (VSN):

Dealer Cost of Unit (Casegood/Accessory Units):

Did Customer Pay a Delivery Fee on The Original Item?

Will Customer Be Responsible For Delivery Fees on Replacement Item?

If NO – Advise Amount of Delivery Fee That Should Be Carried Over To Backsale Ticket From Original Sale

Did Customer Purchase a Third Party Warranty Plan on The Original Item?

Will Customer Be Responsible for Third Party Warranty Fees on Replacement Item?

If NO – Advise Extended Warranty Fee That Should Be Carried Over To Backsale Ticket From Original Sale.

Unit 2:

Customer Name:

Current Customer Full Address:

Address Line 1

Address Line 2

City

State

Zip Code

Current Customer Phone Number:

RMS Service Ticket (If Applicable):

Store Number Where Customer Will Reselect:

City Where Customer Will Reselect:

Brief Reason For Reselection: (i.e. - Store Authorized Courtesy Exchange, RGA Approved, etc.)

ALI For Each Unit:

Style and Cover (VSN):

Dealer Cost of Unit (Casegood/Accessory Units):

Did Customer Pay a Delivery Fee on The Original Item?

Will Customer Be Responsible For Delivery Fees on Replacement Item?

If NO – Advise Amount of Delivery Fee That Should Be Carried Over To Backsale Ticket From Original Sale

Did Customer Purchase a Third Party Warranty Plan on The Original Item?

Will Customer Be Responsible for Third Party Warranty Fees on Replacement Item?

If NO – Advise Extended Warranty Fee That Should Be Carried Over To Backsale Ticket From Original Sale.

Unit 3:

Customer Name:

Current Customer Full Address:

Address Line 1

Address Line 2

City

State

Zip Code

Current Customer Phone Number:

RMS Service Ticket (If Applicable):

Store Number Where Customer Will Reselect:

City Where Customer Will Reselect:

Brief Reason For Reselection: (i.e. - Store Authorized Courtesy Exchange, RGA Approved, etc.)

ALI For Each Unit:

Style and Cover (VSN):

Dealer Cost of Unit (Casegood/Accessory Units):

Did Customer Pay a Delivery Fee on The Original Item?

Will Customer Be Responsible For Delivery Fees on Replacement Item?

If NO – Advise Amount of Delivery Fee That Should Be Carried Over To Backsale Ticket From Original Sale

Did Customer Purchase a Third Party Warranty Plan On The Original Item?

Will Customer Be Responsible for Third Party Warranty Fees on Replacement Item?

If NO – Advise Extended Warranty Fee That Should Be Carried Over To Backsale Ticket From Original Sale.

Receipt Upload: *

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

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