Movietyme.com Defective Returns Form

Please print off and complete this form with every return made.
Customer Name:              _____________________________________________

Date:                       _____________________________________________

Order Number:               _____________________________________________

Date Of Credit Card Billed: _____________________________________________

Disc Title:                 _____________________________________________

Defect Location -

Disc No (if Box Set): _________ Chapter: ___________ Time: _________


Reason For Return

Will Not Start:  _____________

Picture Skips:   _____________

Picture Freezes: _____________

Audio Problem (please explain in full):

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Wrong Disc (if so please state correct disc / version required):

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Packaging (please explain in full):

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Other (please explain in full):

_________________________________________________________________________

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