Warranty Return Form

(Please print form and send with warranty item.)           
Your Name:   ________________________________________________
Address:    ________________________________________________
 ________________________________________________
City:  _____________________ State: ______ ZIP:  ____________
Phone #:  _____________________       Alt. #: ___________________________
E-mail:  _______________________________________
Name of Item Being Returned: __________________________________________
Model:  ___________________________________________________________
Size:  ___________________ Color:  __________________________
Date of Purchase: _________________________________
(Copy of original receipt must be included with warranty submission)
Detailed Description of Claimed Defect: 
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Signature: _________________________________      Date:  ________________
Please ship to the following address: 
 
Trialtir USA
Warranty
5800 Windfern Lane
Houston, TX 77041