Claim Request Form
Shortages, damages in transit, or unacceptable product must be reported within 3 days of receipt of order for consideration of any claim. Failure to complete this form in its entirety may result in denial of claim. Leo Berbee Bulb Company cannot be held responsible for loss due to improper storage, delayed planting, improper planting, inexperience with plant specific growing requirements, and growing conditions out of our control.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
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Alaska
Arizona
Arkansas
California
Colorado
Connecticut
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District of Columbia
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Idaho
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Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
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Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
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Tennessee
Texas
Utah
Vermont
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Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone Number
*
Email
*
example@example.com
Invoice or Order Number
*
Hint - can be located in the upper right hand corner of either Order Confirmation or Invoice
Customer Number
Hint - this is a five digit number that can be located on invoices or order confirmations
Date order received
*
-
Month
-
Day
Year
Date
Date shipments were opened and inspected
*
-
Month
-
Day
Year
Date
Please specify the reason for the claim request
Variety, Quantity affected, Price Each (add additional lines as needed)
*
Photos
*
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Please upload clear pictures showing the issue. Claims without clear photos may be denied.
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