Ugly Fish Eyewear Warranty Claim Form For Warranty claims in AUSTRALIA ONLY
NAME		PRODUCT NAME / CODE
ADDRESS		DATE OF PURCHASE PRICE
CITY STATE		PLACE OF PURCHASE
POSTCODE COUNTRY		IS THIS YOUR FIRST UGLY FISH SUNGLASS? YES     NO
PHONE MOBILE		DO YOU USE PRESCRIPTION EYEWEAR? YES     NO
DATE OF BIRTH GENDER		EMAIL

WHAT IS YOUR PURPOSE OF USE? MOTORCYCLING      MOTOR CROSS SNOW SKI      SNOW BOARD JET SKI      WATER SKI CYCLING      GENERAL USE FISHING      SKY DIVE OTHER HAVE YOU VISITED OUR WEBSITE? YES     NO WOULD YOU BUY UGLY FISH GLASSES AGAIN? YES     NO I WANT TO BE ADDED TO YOUR MAILING LIST? YES     NO PIRANHA EYEWEAR Po Box 482, Fairy Meadow, NSW 2519 AUSTRALIA		DESCRIPTION OF FAULT HOW / WHEN DID FAULT OCCUR? WHAT DREW YOU TO OUR PRODUCT? FUNCTIONALITY      WARRANTY / SERVICE STYLE      PRICE COMFORT      QUALITY OTHER
All information will remain confidential for ugly fish eyewear purposes only