Shortage and Discrepancies Form

You are an existing REBEL distributor and we would like to provide you with an efficient way to complete a shortages and discrepancies requisition using the form below. Please complete all the fields in the form so that we can process your shortages and discrepancies as soon as possible. Please ensure you have read our shortages and discrepancies policy before submitting your request.

Download shortages and discrepancies policy

  • Customer Details

  • Your official company name
  • Your official REBEL customer code. (e.g. ABC001)
  • Must be the same branch that delivered goods to you.

  • Invoice Details

  • MM slash DD slash YYYY

  • Delivery Details

  • MM slash DD slash YYYY

  • Products

    You can list up to 5 line items.
  • Item codeDescriptionQty invoicedQty receivedQty short/over 

  • Supporting Documentation

  • Max. file size: 35 MB.
  • Max. file size: 35 MB.
  • Drop files here or
    Max. file size: 35 MB, Max. files: 5.