Warranty New WARRANTY FORM First Name(Required) Last Name(Required) Email(Required) Phone Number(Required)Address(Required) Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Specify the Phone / Tablet Model(Required) Place of purchase(Required) Upload Picture - Damaged Product(Required)Max. file size: 100 MB.Replacement Type ( Shipping & Handling in the USA )(Required)Premium HD Clear Glass Shield (for phones): $3.99Premium Privacy Glass Shield: $4.99Premium USB Cable: $3.99Premium Protective Clear Case (for phones): $4.99Premium Dual-Port Car Charger Adapter: $4.99Premium PD Wall Charger Adapter: 5.99Premium PD Car Charger Adapter: 5.99Premium PD Wall/Car Charger Cable Combo: $7.99Premium HD Clear Glass Shield (iPad Air2, Samsung Tab3 10.1 or similar size tablets): $14.99NameThis field is for validation purposes and should be left unchanged. 6712