REPLACEMENT
PARTS
FORM
rePLAcement
PArtSORDER
Order FOrm
Phone: 616-456-1613 Fax: 616-456-8091 Email: williamsorders@wmsdist.com 658 Richmond NW, Grand Rapids, MI 49504
Person Requesting Replacement:
Phone:
Fax:
PO #
Customer Account #:
Tag For:
Door Style:
Ship With:
Sold To:
Ship To:
Date:
Original Invoice #
• All orders must supply the original invoice number and very specifically the reason for ordering.
• All damage claims must be reported within 30 days of delivery.
• Original cabinets or parts may require return to JSI for credit.
• Please fax all requests to 508-536-4881 and e-mail any photos of damaged items
• If damage/shortage is done due to the trucking company you must provide a delivery receipt
signed by the driver also stating and damage/shortage noticed at the time of delivery.
Quantity
Item Description
3/1/15 FALL RIVER JS INTERNATIONAL, INC.
Description of Problem
DESIGNER KITCHEN
13