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              Historical Emporium 
            Merchandise Return / Exchange Form  | 
            
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               Your Name and Address 
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               Original Order Info 
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| Name | Name on original order (if not you) | |
| Address | Order number (if known) | |
| City, State, Zip | Order date (if known) | |
| Phone | ||
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               Item(s) being returned 
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| Qty | Description | 
              R=Return E=Exchange  | 
            Reason Code (see below) | 
| R / E | |||
| R / E | |||
| R / E | |||
| R / E | |||
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               Additional Comments 
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              Reason Codes A: Wrong Size B: Did not like / changed my mind C: Received as a gift D: Quality not as expected E: Item damaged / defective F: Arrived too late G: Other (please explain)  | |
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               Item(s) Requested (Exchanges Only) 
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| Qty | SKU/Description | Size Requested | 
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              Historical Emporium 
            Attn: Returns 188 Stauffer Blvd. San Jose, CA 95125  | 
            
            
              
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              Return / Exchange Instructions:Carefully pack the items being returned, and enclose a copy of this form with your shipment. Return by UPS or USPS Priority mail to the returns address above. We charge standard shipping for all exchanges; unless you tell us otherwise, we'll use the original payment method. Any refunds will be issued via the original method of payment. Questions? Special needs? Contact us at 800-997-4311 or www.historicalemporium.com/contactus.php to send an email.  | 
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