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Fields marked with an are required.

required
required YES      NO
E-mail      Phone      Fax      U.S. Mail
 
Contact Information:
(If phone, please list best time to call)
 
Part type: required
Part number:
(If available)
Part brand:
(If available)
 
Why do you suspect the part is counterfeit? required
 
Where did you purchase the part?
Name: required
Address: required
City: required
State: required ZIP Code: required
Country: required
 
ALL PERSONAL INFORMATION WILL REMAIN STRICTLY CONFIDENTIAL.

Fax:   (313) 665-6672

Phone:   Awareline 800-244-3460

Mail:    
 ATTN: Global Brand Protection
 300 Renaissance Center
 MC: 482-C09-C22
 Detroit, Michigan 48265



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