DAMAGES

PLEASE FILL OUT, PRINT AND PIN TO EACH ITEM THAT IS BEING SENT TO DAMAGES AND GIVE TO LAURA

DATE SUBMITTED *

mm/dd/yyyy

SUBMITTED BY *

Enter the name of the person submitting this form.

LOCATION OF ITEM *

ITEM NUMBER *

CUSTOMER NAME IF APPLICABLE

WAS IT SOLD? *

DESCRIBE THE DAMAGE *

WHAT DO YOU RECOMMEND WE DO WITH IT? *

CAN IT BE REPAIRED? *

*

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