Chiliwear Wallets Exchange Form

Exchange Verification Information

Dear Customer:

We will be happy to replace your wallet. It allows us to show you our commitment to your satisfaction.

In order for us to process this transaction in a timely manner, please provide us with the information requested below. You will then be linked to our online exchange center.

(Note: If this wallet was a gift, please provide as much information as possible from the original purchase.)

	Billing Information
First Name
Last Name
Street Address
Address (cont.)
City
State
Zip
Day Phone
Evening Phone
E-mail

Shipping Information (if different than above)
First Name
Last Name
Street Address
Address (cont.)
City
State
Zip
Day Phone
Evening Phone
E-mail

	Order Number