McLeod Industries
Return Goods Authorization Form (RGA)

A form MUST Accompany any return to the factory

Warranty returns must includes sales receipt.

No returns will be accepted without an RGA # (return goods authorization number) and this form. You will receive an RGA # with your email confirmation after submitting this form.

PLEASE PRINT THIS FORM USING YOUR BROWSER'S PRINT BUTTON BEFORE CLICKING THE SUBMIT BUTTON.

*Denotes required information. Failure to provide may slow processing of your repair.
Your Information:
Date    
Name* Address*
City* State*
Zip* Daytime Phone*
2nd Phone Email Address*
Your Vehicle Information / Engine:
Make* Model*
Year* Engine*
Tire Size* Weight*
Est. HP*    
Package Contents (enter quantity):
Pressure Plate                    
Please list in detail the work you want completed on your clutch or the problem you encountered
Stock Adjustment

RGA # ___________ (Fill in RGA# at left and write it on the outside of your package.You will receive an email confirmation with an RGA # once you submit this form.)
FOR YOUR PROTECTION:

The following information will not be submitted via the internet.

Please follow the instructions below for printing out and submitting this form – then fill in the appropriate credit card information and signatures before including the completed form with your parts.

How do you want parts returned to you?

___ UPS Next Day     ___ UPS 2-Day     ___ UPS 3-Day     ___ UPS Ground     ___ UPS Freight

Method of Payment

___ VISA    ___ MasterCard    ___ Discover    ___ AMEX    ___ Check    ___ Factory Warranty

DO NOT EXCEED: $_________ Enter highest amount you pre-approve for services, along with payment information below. Leave blank if you prefer us to call you with all estimates.

Card Number (NOTE: AMEX is only 15 digits)

                               
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Name as it appears on Card (Required): _______________________________________

Signature of Cardholder (Required): ___________________________________________

Expiraton Date (Required): _____ - _____

CVV Code (Required): _____ (The CVV is the last 3 digits AFTER the credit card number in the signature area of the card, on AMEX cards it is 4 small numbers to the right and above your account number.)
PRINT this form BEFORE clicking on the submit button and RETURN a copy of this form with your shipment.

You must enter the RGA # you receive in your email confirmation, return-shipping choice, and payment information on this form before returning any parts.

Shipping Address:
McLeod Industries
Attn: Returned Goods
1600 Sierra Madre Circle
Placentia, CA 92870