Claim Number

Status:

Submitted on

Customer Info

Full Name:
Email:
Country:
State/Province:

Claim Info

Order Number (if purchased on Herschel website):
Retailer (if bought in store):
Purchase Country (if bought in store):
Purchase Province/State (if bought in store):
Purchase Date:
Product Category:
Product Name:
Defect:
Additional Details:

Comments

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