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Contact Information
Name*
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Email*
Phone*
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Product Information
Item#
Product Description*
Describe the problem you are experiencing*
Please upload images of the entire front of product, back of product, and the purchase receipt.

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Upload up to 4 pictures (less than 10MB each). Accepted file formats: JPG, GIF, PNG, PDF.
Purchase information
Retailer Name*
City*
State*
Approximate Date of purchase*
Please note, in some instances we may require the defective product to be mailed in for warranty replacement.

Screen Shine