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30-Day Refund Form

Product

Select the product you are returning.
If your product is not listed, contact customer service.

  
Describe the reason for returning your product:
 

Etymotic Invoice Number:   

Billing Address

Full Name:
 
Address 1:
 
Address 2:
City:
 
State:
Zip/Postal Code:
 
Country:


Phone:
 
Email:
 
Verify Email:
 
 

Credit Card Information

Card Type:


Card Number:

Security Code:
The 3 digit security code is located on the back of your credit card.

Expiration Date:
Month   Year
/

 
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