---
title: Return and refund request form template, free
description: A free return and refund request form template. Ask to return an item: the order, the item, the reason, the outcome wanted and photos, approved by the seller. No card details are collected. Publish it as one link; every response is its own signed copy.
---

# Return and refund request

Ask to return an item: the order, the item, the reason, the outcome wanted and photos, approved by the seller. No card details are collected.

Handle every return in the same way, with evidence and a signed decision.

## About you

- Full name (text)
- Email (email)
- Phone (phone, optional)

## Your order

- Order number (text)
- Purchase date (text)
- Item (text)
- Quantity (text)

## The return

- Reason (choice)
- Details (text, optional)
- Outcome wanted (choice)
- Photos (file (PDF or picture), optional)
- The item is in the condition described, and I will return it as instructed. (tick box)

## Signature

- Customer signature (signature)
- Customer date signed (date signed)

## For seller use

- Decision (choice)
- Note (text, optional)
- Seller signature (signature)
- Seller date signed (date signed)