Qunince

Jewelry Warranty Claim Form
If you have questions while completing this form, please contact us. Phone: 1.800.854.7464 • Email Customer Service

First Name and MiddleInitial

Last Name

Date (mm/dd/yy)

Address Line 1

Address Line 2

City

State

Zip

Phone Number

Email Address

Your phone number and email address willonly be used to contact you with questions regarding this request.

School Name High School College Other

School City

School State

Graduation Year Regardless ofthe reason you are returning your jewelry item for warranty work, if your item has your personal signature for inside engraving, please provide it again inside the bracketsADJUSTMENTS:
Please specify the exact part of your jewelry item that needs to be corrected. Provide detailed instructions, including new information, if you are requestingchanges.

PAYMENT INFORMATION*
If charges apply for the warranty work on your jewelry item, we will contact you by phone or email you with the information. Payment must bereceived prior to any warranty work being started.

Check Money Order

Debit/Credit Card:

Visa

MasterCard

American Express

Discover

Card # SignatureExpires
(mm/yy)

SHIPPING INFORMATION
Return your jewelry item in a PADDED ENVELOPE, via INSURED MAIL, with this printed form to: WARRANTY SERVICE • 1900 HARTLE AVE •OWATONNA, MN 55060 Please insure your jewelry item when shipping. Warranty coverage applies to the original item owner and items must be in repairable condition. If upon receivingyour jewelry item, charges apply, Jostens will notify you prior to proceeding with your warranty request. Charges apply to customer changes.
© 2006 Jostens, Inc.