Customer Information Form - Brilliance

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Brilliance Customer Information Form
Order Information:
Order Information:
Order Number(s)*:
_____________
_____________
______________
Order Name:
____________________________________________
Product Description:
____________________________________________
Instructions:
Contact Information:
Return Shipping Address (please include name if di erent than original order):
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Phone Number:
_____________________
Email Address:
_____________________
*PLEASE WRITE YOUR ORDER NUMBER CLEARLY ON THE OUTSIDE OF YOUR PACKAGE.

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