Customer Repair Return Form

Please complete all applicable fields of this form.

Download and attach a copy to your warranty return.

Name Address City State / Province / Region Phone Number Email Preferred Contact Method EmailPhone Product Place of Purchase Received as a GiftYesNo Reason For Return PRE- AUTHORIZATION: If your item is not covered under warranty, but you still want to have the required repairs done, do you hereby authorize repairs costing up to $50.00? (In the unlikely event that the cost of repair exceeds $50.00, we will contact you for authorization. Product w/o repair authorization will be returned after 30 days) YesNo PRODUCT RETURN/REPLACEMENT OPTION: If your returned warrantable item cannot be repaired for whatever reason, would you accept an equivalent replacement item or would you want the original item returned to you in an "as is" condition at no additional cost? ReplaceReturn Sign

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