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A DIVISION OF BETTS SPRING COMPANY v� <br /> SINCE 1866 <br /> ❑ San Leandro ❑ Fresno Sacramento Santa Fe Springs <br /> 950 Doolittle Drive 2867 S Maple Ave. El 1121 Striker Ave,Ste 100 El 9315 Santa Fe Springs Rd, <br /> San Leandro,CA 94577 Fresno,CA 93725 Sacramento,CA 95834 Santa Fe Springs,CA 90670 <br /> Phone-510.633.4500 Phone-559.498.8624 Phone-916.928.3818 Phone-562 941.2300 <br /> 688.828E175(888.822.3887) 800.330.3245 800.704.4089 800.541.5613 <br /> Fax- 510.633.4505 Fax- 559.457.0149 Fax- 916.928.3816 Fax- 562.941.2260 <br /> Fontana Almond Ave. RiporVManteca Portland Phoenix <br /> 10771-8PO Box 509,Ripon,CA 95366 4334 NE Columbia Blvd. 7375 W Buckeye Rd,Ste 100 <br /> Fontana,CA 92337 3025 E Palm Ave,Suite 104 Portland,OR 97218 Phoenix,A2 85043 <br /> Phone-909.427.9988 Manteca,CA 95337 Phone-503.289.8875 Phone-623.907.9396 <br /> 800.66BETTS(800.662.3887) Phone-209.599.1600 800.378.8766 800.545.0283 <br /> Fax- 909.427.9946 Fax- 209.599.1643 .Fax-503.289.3515 Fax- 623.936.5713 <br /> PARTS/CORE RECEIPT- <br /> J4 <br /> Price Adjustment Return - Mfg. Item r ^o 9 ; <br /> Return - Stock Item Return -Core <br /> Acct. # rK)— `- 't,-a 0 i a <br /> Customer `r kra:' UAmount of Credit $ <br /> Address Restocking Charge $ <br /> Orig.Tag # <br /> -- <br /> QUANTITY QUANTITY QUANTITY PART NUMBER UNIT COST <br /> • <br /> PICKED UP • . REJECTED <br /> X X <br /> i Customer Betts Spring Company <br /> Credit to be issued upon inspection that Core is repairable or Parts have not been <br /> used. If Core is not repairable or Parts have been used, no credit will be issued. <br /> Credit will not be issued on Special Ordered or Special Manufactured items. <br /> For Office Use Only <br /> X <br /> Core/Parts Inspected By <br /> Remarks: Authorized by: <br />