Ruthie's Run Merchandise Return Form

Please return the merchandise and this form to:

Ruthie's Run
2415 Main Street
Lake Placid, NY 12946

Please indicate which you are requesting:    refund      or      exchange

Shipping Information

Name: ___________________________________________________________

Address: ___________________________________________________________

City: ___________________________________________________________

State: _____________________________ Zipcode: ____________________

Telephone: ___________________________________________________________

Email: ___________________________________________________________

Billing Information

Name on Card: ___________________________________________________________

Address: ________________________________________________________________

(if different from shipping address) ____________________________________________

Card Type:   Mastercard    Visa     American Express    Discover

Card Number: _________________________________ Expiration: ____________

CVC Code: _____________


Reason for Return:

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________