Refund Request Form

A refund request form turns "I want my money back" into something both sides can act on. It identifies the order and the receipt, lists exactly which items and how much, records the reason, says how the money should come back, and gives the seller a place to write down the decision. For the customer it is a clear request with a date on it; for the seller it is a record of what was asked, what was decided and who approved it.

You can use it from either side. A shop can send or print it for customers, who fill in their part, or a customer can fill it in and send it to the shop. The items table multiplies quantity by unit price, adds the lines and any shipping you ask back, and shows the total you are requesting. If the money should come back by bank transfer, the bank fields appear. They are typed for this one request and are not added to your saved profile.

The form points to consumer rules but does not decide which of them applies. Many countries give buyers rights apart from a shop's own policy, such as a remedy for faulty goods or a period to withdraw from a distance purchase, and the notes for each country name the main rule. Pick a country to get those pointers and the matching bank fields: the branch and account type in Japan, the 14-day withdrawal pointer in Germany, the approval boxes in Korea and Japan.

• You are returning faulty, damaged or wrong goods and want the request in writing.
• You run a shop and want customers to give you the same details every time.
• A payment was taken twice, or for goods you never received.
• You want the approval recorded: who decided, how much, on what date.
• The refund goes by bank transfer and you need the account details on the request.

1. Fill in the order number, the date of purchase and the receipt number, and say how the order was paid.
2. List each item to refund with quantity and unit price. The amounts and the total are worked out; add shipping if you want it refunded.
3. Tick the reason and describe the problem under details. Attach the receipt, photos or the item, as the seller asks.
4. Choose how the money should come back. For a bank transfer, enter the account for this request only.
5. Sign and date it. The seller then ticks the decision, writes the approved amount and signs. Both sides keep a copy.

• Leaving out the order or receipt number, which delays everything.
• Listing items you are not returning, so the total is wrong.
• Writing "refund" without saying how, so the money goes back by a method you did not expect.
• Assuming this form replaces a statutory notice. Where the law has a specific notice or form, use that as well.
• Sending bank details by ordinary email. Hand the form over or use a channel the seller recommends.

1. Fill in
2. Check the preview
3. Save as PDF, Word or Excel

Pick the country you need. Each version uses the wording and layout commonly found there; a version marked “check with local advice” should be read by someone who knows the local rules before it is used.

• International (XX): Written in English, Korean, Japanese, German
• United States (US): Written in English – check with local advice
• United Kingdom (GB): Written in English – check with local advice
• Korea (KR): Written in Korean, English – check with local advice
• Japan (JP): Written in Japanese, English – check with local advice
• Germany (DE): Written in German, English – check with local advice