Create new Cylinder Return

Fill in required fields below:

1. Fill in the request form below
2. Ensure email address is entered correctly as we use this to send all relevant paperwork required for a successful return.
3. Hit the submit pickup button.
4. Once the pickup order has been processed you will receive an email with an attachment containing labels, manifest, and connote documents.
5. Connote labels are to be attached onto the boxes; DG form and the manifest to be handed to the driver upon collection.
6. If you need to cancel this pick up booking, please call 03 9358 5999 and quote the your reference number from your email.

Select Retailer

Search Store Name or Enter Store No.

CustomerNo

Store Number

Store Name

Contact 1 Full Name

Contact 2 Full Name

Contact Phone No.

Contact E-Mail Address

Please ensure this e-mail address is correct as it will be used to send all correspondance and shipping information.

Confirm E-Mail Address

Address

Address 2

Suburb

Post Code

State

Pickup Location

Earliest Pickup Time

Latest Pickup Time

How Many Cartons

Instructions

I acknowledge all cylinders packed in this carton are Phillips Water branded Cylinders

I acknowledge the dangerous goods declaration will be attached to the cylinder pack before collection

I acknowledge that a futile pickup fee of $40ex GST will be charged to my account if the stock is not packed, labeled and ready for collection when the courier arrives

I acknowledge that the information I have given is correct

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