To,

Date: ___/____/2012

WS Retail Service Private Limited

No. 447, 1/B, 1st Floor, 1st A Cross,
12th Main, 4th Block,
Koramangala, Bangalore-560034

Place:

DECLARATION CUM UNDERTAKING

Ref: Refund of Rs. ____________/- (Rupees _____________ Only) in lieu of

return/reject of ____________(mention product description) (referred to as
Product).

Dear Sir/Madam,

I. ________________________ S/D/W/o ____________________ an Indian inhabitant

residing
at
____________________________________________________________________________
______________________________________________________________________________
hereby, declare that I have placed order for the Product vide order No.
_________, said Product is returned for the reason _____________________________
(mention reason). Further I, state that the payment made with respect to the
Product is paid through bank account held by third party i.e., Mr/Ms.
_______________, with Account No._______________________, _______________
Bank, ____________ Branch, IFSC Code: _________________.
I request you to refund Rs. ______________________(Rupees ____________ Only)
to the aforesaid account by way of refund through NEFT and I hereby agree
and undertake that the refund made in the aforesaid manner shall give
Flipkart.com valid and complete discharge in respect of the Flipkarts
obligations to refund the aforesaid amount to me.
I hereby agree to indemnify and keep you fully and effectively indemnified of,
from and against all costs charges and/or expenses that may be caused to or
suffered by you, as a result of any future claims on the refund/Product by me
and/or from any one claiming under me. I shall not dispute or contest the
existence, execution, veracity or validity this Document.

Yours faithfully

(name:_________________)
Contact Number: ________________________