Return Authorization Form

After you fill out this form, you receive a Return Authorization Number (RA#) via email.

First Name (required):

Last Name (required):

Address:

Address 2:

City:

State / Province / Region:

Zip:

Country:

Email (required):

Phone (required):

Problem Area:

Description:

Message:

 I would like to occasionally receive information on new products, updates, and special promotions from Adcor Defense (Personal information will not be shared).

 

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