Embedded Content - Inside Safariland

"*" indicates required fields

Agency:*

Contact Name:*

Shipping Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Day time Phone:*

Email*

Dealer Name:

Date Purchased:

Headset Model:

Reason for Return?*

*You must know the serial number to place a claim. If you do not know the serial number, please call customer service at 1.800.347.1200 and select option 5.

Quantity Being Returned*

Serialization Number*

Additional Details of the problem and any special instructions: