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Return Claim

Your First Name

Your Last Name

Your Email

Your Phone

Company Name

Billing Address

Billing Country

Billing State

Billing Province

Billing Zip/Postal Code

Billing City

Shipping Address

Shipping Country

Shipping State

Shipping Province

Shipping Zip/Postal Code

Shipping City

Item Model Number

Item Description

Item Serial Number

Purchase Invoice Date (mm/dd/yyyy)

Host Machine Make/Model

Purchase Invoice Number

Reason for Return: (include the attachment model and serial number)

Upload Photos of Item

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