Approx. Date Product was Delivered to You:_________________

Product Returning: ____________________________________________________

Amount Paid: __$________________  

 Name: __________________________________________________

 Address: ________________________________________________

City: _______________________ State: _________ Zip: __________

E-Mail Address: ___________________________________________

 ****Please print clearly, this will be your shipping label for the new item.****

Reason for Return: (If error when using product please describe the error)

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

Please Sign Here: _______________________________________ Date: ____________________

Print & fill in this form and mail it along with the item you are returning to the address below.  Any returns without this Authorization will not be accepted.

1^st Texas Sales

1217 Limetree Lane

Irving, TX 75061-4531

ATTN: Returns Desk