Warranty Claim Name * First Name Last Name Company Name (if applicable) Address * *If found to be within warranty period, this is where the replacement will ship Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Catalog No. / Serial No. (indicated on product label) Quantity Not Working * Date of First Failure * MM DD YYYY Date of Invoice MM DD YYYY Nature of Problem * Failed to turn on after a period of time Began flickering/shimmering/strobing after a period of time Other (add details below) Additional Details Thank you!
