Liberty Tobacco Return Form

Please print this form and fill out completely.

1. Name: ________________________________________

2. Address (Street, City, State, Zip):

________________________________________________________________________

3. Return Authorization Number: __________________________

(Please obtain this number by contacting customer service at 1-(858) 292-1772 or by emailing info@libertytobacco.com Packages without this number will not be accepted.)

4. Item(s) Returning (please include product number and description):

i.e. "4372 Ardor Calabash"

________________________________________________________________________

5. Reason for Return. Please check appropriate box:

[ ] Did Not Receive Item in Time
[ ] Item received is not as Described
[ ] Item is Damaged
[ ] Found Elsewhere Cheaper
[ ] Other, Please Specify
[ ] Wrong Item Received
[ ] Wrong Engraving Received
[ ] Item received is not as Pictured
[ ] Item is of Poor Quality
[ ] Personal Reason

________________________________________________________________________

6. Contact me regarding the Wrong / Damaged / Defective Merchandizing

[ ] Yes
[ ] No

7. Type of Return. Please check the appropriate box:

[ ] Refund the money in the form of original payment.
[ ] Exchange for another item (please indicate item in comments below).

8. Any further comments

________________________________________________________________________

For your protection, please send all returns via registered and insured mail to:

Liberty Tobacco
7341 Clairemont Mesa Blvd.
(Ethan Allen Shopping Ctr.)
Clairemont, CA 92111

In order to protect the package against possible theft, please do not write pipes, cigars, humidors or any other luxury related word on the package. Liberty Tobacco cannot be responsible for return shipping losses.