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475 14th Street, #650 Oakland, CA 94612 P.O. Box 71107 1.800.617.4729 1.877.517.4729 www.SterlingHSA.com request for return of mistaken employer contribution(s) to a health savings account This form
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How to fill out a request for return of:

01
Start by clearly stating your intention to return the item or request a refund. Include the relevant details such as the product name, purchase date, and order number if applicable.
02
Provide a brief explanation as to why you are returning the item. This could include reasons such as receiving a defective or damaged product, wrong item delivered, or simply not satisfied with the product.
03
Clearly state your desired outcome, whether it is a replacement, refund, or exchange for another item. Specify any specific preferences or instructions related to the return process.
04
Include any supporting documents or evidence that can strengthen your case, such as photographs of the defective item, receipts, or packaging slips.
05
Provide your contact details, including your name, address, phone number, and email address. This information is essential for the seller or customer service representative to reach out to you regarding your request.

Who needs a request for return of:

01
Customers who have received a defective or damaged product that needs replacement or refund.
02
Customers who have received the wrong item and need to return it for correction or replacement.
03
Customers who are not satisfied with the product and wish to return it for a refund or exchange for a different item.
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Individuals who have made accidental duplicate purchases and need to return one of the items.
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Businesses or organizations who have received incorrect or unsatisfactory products as part of a bulk order and need to arrange for a return or replacement.
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The request for return of is for requesting a refund or return of funds.
Anyone who is eligible for a refund or return of funds is required to file a request for return of.
You can fill out the request for return of form online or by mail.
The purpose of the request for return of is to receive a refund or return of funds that are owed to you.
You must report your personal information, account details, and reason for requesting a refund on the request for return of form.
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