ShopUW+ Merchandise Return Pick-up Request Form Use this form to request MDS pick up your ShopUW+ merchandise returns. CommentsThis field is for validation purposes and should be left unchanged.Contact person name(Required) First Last Contact person phone number(Required)Contact person email(Required) Vendor(Required)At this time MDS is only able to pick up returned merchandise for these vendors.StaplesVWRFisherReturn authorization number or invoice number(Required)Pick-up requests cannot be submitted without one of these numbers.Department name(Required)PO number (if known)Building name(Required)Building address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Total number of packages to be picked up(Required)