From:

Name__________________________________


Street________________________________


City__________________ State__________


ZIP Code_______________

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Ship To:

THE DRIP STORE, Inc.
980 Park Center, Ste.  E
Vista, CA 92081

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ATTN: WEB RETURNS

RMA#
____________________________

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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!