Repair Exchange Item Pickup Form

To return a part from EMPR® Australia, simply fill in the form below and click submit.

This form is used to book a pickup for the return of your defective repair exchange item.
Note: A separate booking is required for each defective repair exchange item pickup!

Pickup Address Details :

Please check the full address details of where the part is to be picked up from, including contact name and phone number.

Note: If picking up from a company address please ensure you include this in your pickup address details as the method of contact offered by our Logistics Partner Australia Post differs depending on this detail.

Name*

Email*

Company*

Phone*

Address*

Suburb*

State*

PostCode*

Fax

Return Information :

Please ensure that you fill in all the required information. Required information is marked with an asterisk *. Place any special instructions into the box provided.

Note: To ensure no additional costs are charged to your account please return your defective exchange part to EMPR®Australia in the original packaging as supplied by us.

Item Number*

REN/RMA Number*

Pickup Date*

Special Instructions*

By submitting this form you are confirming that you have read and understood the Terms & Conditions of EMPR® Australia.