Missing Items Form

To report missing merchandise or a lost shipment
1) Print out this page.	3) List missing merchandise.
2) Clearly print name, address, etc.	4) Sign form & mail to the address below
High-Tech Productions, Attn: Shipping Dept., P.O. Box 3506 Boca Raton, FL 33427

Name_________________________________ Invoice #____________

Address_______________________________ Phone #______________

City_________________________ State________ Zip_____________

Date Order Was Placed ____/____ How (Circle One) Phone Fax Web Mail

*Desired Action* Circle One: Replace Refund

Missing Item Description	Qty.	Price each	Total






Total Amount of Merchandise

Please read & sign
I hereby declare that I have not received the above listed merchandise and that all information provided by me
is correct. Furthermore, I understand that the willful giving of false information in order to avoid the payment for
goods, services and/or merchandise is a federal crime.

Signed ________________________________ Date ____/____/____