Screen No. : LC221
Refund Form
Invoice Party Name :   Refund Party Name :  
BLNO :   Payment Rec. No :  
Customer Code :   Payment Rec. Amt :  
Refund Request Amt :   Customer email address :  
Reason for Refund :
Alternate email address :
Mobile No :   Phone No :
Line Segregation :
Currency :
Customer Bank Details
Account Holder Name :   Complete Bank A/C No :  
Bank Name :   IFSC Code :  
Swift Code :   Bank Address :  
Upload Documents
Document Type :
SR NoDoc NameUpload DateFile TypeDelete
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Comments :
Disclaimer : The deposit form is not verified at the time of acceptance. Final credit is subject to realization.
B/L and/or DO, as the case may be, shall be released only after freight & all other charges paid fully.
* Please attach NOC in case of third party refund payment.

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