EmailMe Form - Blue Seal Claim Form

Claim Form - Start Process Here
KLC Employee Name *
First Last
KLC Employee Email *
Store: *
Whitinsville
Uxbridge
Grafton
Product Name (please include size): *
SKU: *
Blue Seal Lot Number (date code): *
Quantity: *
When was problem found?
In Store - prior to sale
By Customer after purchase
Customer Name (if Applicable):
Customer Email (if Applicable):
Customer Phone (if Applicable):
### - ### - ####
Date of original purchase (as close as possible, if applicable)
MM / DD / YYYY
Reason for claim: *
Please attach photos of close up, and overall condition of the product: *

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