Customer Name___________________________________________________
Address            ___________________________________________________
                         ___________________________________________________
RGA Number   ___________________________
Date of Purchase    ___/__/______ (must be within 60 days)
Daytime number ( ___  ) _____ -________
Email Address _____________________________
Year, Make, Model of Vehicle______________________________________

I understand the terms and conditions of returning or exchanging product purchased from Rimz One
which are posted on the policy page under returns and exchanges.

                                         __________________________________________
Signature Required
 

IMPORTANT:  
                          Rimz One is not responsible for installation of product. Verification that all merchandise has been received is the responsibility of the purchaser. Under no circumstances is The Rimz One responsible for any labor or incidental charges, including those related to warranty, defective, damaged, or incorrect merchandise.                                             

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