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Making sure the merchandise is securely protected. 3. Ship via U.S. Mail or any transit service, being sure to insure the merchandise to your satisfaction. ___________________________________________________________________________________________ Date Mr. Ms. Mrs. Name: Address: City: State: Day Time Phone: Extension: Zip Code: Evening Phone: Email Address: Was this merchandise previously serviced by Tiffany & Co.? If yes, when? Please provide the name of the original purchaser, if.

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