Return Shipment Form

Return Shipment Form

Please complete and place this form inside your return parcel
Customer & Order Details
Full Name:

First NameLast Name
Shipping Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile:
Company Name (if applicable):
Email Address:
example@example.com
Phone Number:
Please enter a valid phone number.
Order/Invoice Number:
Purchase Date:

MonthDayYear
Date
Content of Shipment
Returning Items:*
Diamond Certificate/ Grading Report

I am enclosing the original diamond certificate (GIA / HRD / IGI / other)I am not enclosing the certificate
Note: If sending the original certificate, place it in a separate envelope inside the parcel to prevent bending. We recommend keeping a photo or scan for your records.
Reason for Return / Service Request
Return / refund requestSize adjustment / resizingRepairCleaning & polishingQuality issueWarranty claimOther
Additional Comments or Instructions
Contents Confirmation
Items enclosed in this parcel (tick all that apply):

Jewellery piece onlyJewellery piece + original Philippe Harold boxJewellery piece + diamond certificate / grading reportOther accessory (travel pouch, etc.)
Date

DayMonthYear
Date
Signature

Clear
Confirmation: I confirm that the item(s) listed above are the only contents of this parcel.
Should be Empty: