Birdz Warranty Claim
1. Print out this form and fill it out completely. Any missing or incomplete information will DELAY the processing of your claim.
2. Send us ALL of the following:
     * Reason for return _______________________________
     * Completed form below
     * Copy of your receipt
     * $6.95 (USA residents) shipping/handling/processing payment ($9.95 International)

We encourage you to send by a traceable method as Birdz Eyewear is not responsible for lost or misdirected packages.

Print your information:

Phone (_____) ________________

___________________________________________________
Name

___________________________________________________
Shipping Address

___________________________________________________
City, State, Zip

___________________________________________________
Email address

Send To:

Birdz Eyewear

Attn: Warranty and Repair

P.O. Box 744

Crown Point, IN 46308

Payment Info: (Please PRINT)

Please include payment for $6.95 USA ($9.95 International) which includes shipping/handling/processing of your warranty claim. Make checks payable to Birdz Eyewear.

Credit Card Information (if applicable): (Please PRINT)

Card Holder's Name (as written on card)________________________________

Card Type Expiration Date _

Card Number___

Credit Card Billing Address (if different from Ship To address)

_

_____________________________