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Run: Battery Core Return Receipt and Credit Form

Track returned battery cores, verify condition, and document core credit in one receipt form. Use it to reduce disputes, capture required acknowledgments, an...

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Transaction & Store Information

Return Date (required)

Date the battery core is being returned.

Return Transaction Number (required)

Auto-assigned or manually entered transaction reference number.

Store / Branch Location (required)

Associate Processing Return (required)

Customer Information

Customer Full Name (required)

Customer Phone Number (required)

Used to look up original purchase and issue credit.

Customer Email Address

Optional — used to send credit confirmation receipt.

Account / Loyalty Number

If the customer has a store account or loyalty membership.

Original Purchase Details

Original Invoice / Receipt Number

Provide if available. Core returns may be accepted without receipt per store policy.

Original Purchase Date

Approximate date of the original battery purchase.

Original Payment Method

Battery Core Specifications

Battery Type (required)

Select the lead-acid battery category being returned.

BCI Group Size

Battery Council International (BCI) group size code found on the battery label.

Battery Brand / Manufacturer

Part Number / SKU

Voltage (V) (required)

Number of Cores Returned (required)

Core Condition Assessment

Overall Core Condition (required)

Is the battery case cracked or broken? (required)

Is there visible acid leakage? (required)

Leaking batteries require special handling per EPA 40 CFR Part 266 Subpart G (used lead-acid battery management).

Acid Leakage / Hazard Handling Notes

Describe containment steps taken if acid leakage was present.

Are both terminals present and intact? (required)

Additional Condition Notes

Core Condition Photos

Attach photos of the returned core, especially if condition is Poor or Rejected.

Core Credit Calculation

Core Charge Per Unit ($) (required)

The core charge amount listed on the original invoice or per current price list.

Credit-Eligible Quantity (required)

Number of cores approved for full credit (may differ from returned quantity if some are rejected).

Total Core Credit Amount ($) (required)

Total credit to be issued (core charge per unit × credit-eligible quantity).

Credit Issuance Method (required)

Reason for Partial or No Credit

Required if credit-eligible quantity is less than the number of cores returned.

Customer Acknowledgment & Consent

I consent to my contact information being used to process this core return credit and issue a receipt. (required)

Your name, phone number, and email (if provided) will be used solely for this transaction and retained per our data retention policy.

Yes No N/A

I confirm that the battery core(s) I am returning are lead-acid type and were originally purchased from this store or an affiliated location. (required)

Yes No N/A

I understand that returned cores will be sent for lead-acid battery recycling in compliance with applicable regulations. (required)

Lead-acid batteries are regulated under EPA 40 CFR Part 266 Subpart G and applicable state laws.

Yes No N/A

Customer Signature (required)

Sign to authorize the core return and credit issuance.

Associate Signature (required)

Associate signature confirms core was received and condition was assessed.

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