CITIZEN REPAIR SUBMISSION FORM
Please complete the following service form and include it in the shipment back to our service center. Keep one copy for your records.
Name
*
First Name
Last Name
Email
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Describe the problem.
Watch Information
Can you read the caseback information?
*
Yes
No
Caliber and Case Number
Serial Number
How do you wish to receive your free mailing label?
*
Print it now or send it to my email
Sent to me in the mail
Date
Submit Form
Should be Empty: