From:

Name__________________________________ Street________________________________ City__________________ State__________ ZIP Code_______________ ------------------------------------------

Ship To:

THE DRIP STORE, Inc.

980 Park Center, Ste.  E

Vista, CA 92081

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ATTN: WEB RETURNS

RMA#

____________________________ -----------------------------------------------Fold Here------------------------------------------- Fold on dotted line above and also in half leangthwise. Then tape completed form onto package. Make sure to fill in all blank information. Thanks!