| Date:
__________________________________ |
| Name:
___________________________________________________________________________________________ |
| Street
Address (No P.O. Boxes Please!): _______________________________________________________________ |
| City:
____________________________________________________________________________________________ |
| State:
___________________________________________________ Zip:
____________________________________ |
| Telephone
number where we can contact you: __________________________________________________________ |
| e-mail
address:_________________________________________________________________________________________ |
| Type
of ammunition used:____________________________________________________________________________ |
| Description
of your problem: _________________________________________________________________________ |
| _________________________________________________________________________________________________ |
| _________________________________________________________________________________________________ |
| _________________________________________________________________________________________________ |
| _________________________________________________________________________________________________ |
| _________________________________________________________________________________________________ |
| _________________________________________________________________________________________________ |
| _________________________________________________________________________________________________ |
| _________________________________________________________________________________________________ |
To
prevent damage, please ensure that you package your
firearm well when you ship it. Please include any magazines
that you were using with your firearm.
Please
include this form with your firearm.
|