CS-FR-201 Owner Approval: Tech Services Manager Rev: E Rev Date: 04.21.2021 Page 1 FIELD DESTROY AUTHORIZATION CURT GROUP CUSTOMER NAME DATE SUBMITTED CURT GROUP CUSTOMER ACCOUNT NUMBER PHONE NUMBER SUBMITTED BY *Qty *Part# *Description of Defect *Original Invoice / PO# Cost Total This form, along with a photograph of the product(s) destroyed, must be completed and sent back to CURT Group for approval and credit to be issued. Email to returnsdepartment@curtgroup.com. Enter the customer name and PO# in the subject line. * Required fields. This field is required to be filled out for credit to be issued in a timely matter. Failure to complete this field could result in a delay of the credit being processed. This form is to be completed by a CURT Group customer, not end-users / consumers. Complete one form per invoice / PO#. Cost and Total columns are for accounting use only. APPROVED BY ACCOUNTING DATE CM# PRINT NAME CURT GROUP CUSTOMER SIGNATURE Office Use ONLY 6208 Industrial Drive Eau Claire, WI 54701 877.287.8634 Phone