Your Authorization return number :_____________________
Your confirmation order number : Order ID #:_____________
In the event you do not have the Order ID #:  list the Ref: 1 (number located on the left lower corner on the UPS label)  _____________ ,
The day we charge your credit card. ___/___/___

1:  Your last name:  ________________________________
2:  Your first name:  ________________________________
3:  Your phone #:   _________________________________
4:   Your Email : _______________________________________________

Your delivery address:

1:  Your Street : ___________________________________
2:  Your City:      ___________________________________
3:  Your  State:  _____  Your Zip:_______________________

Give a  reason for return (please describe).

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