Return Form

Marquis Gold Co. respects your privacy. Please refer to our Privacy Policy for details.

Please fill out as much as you can for a speedier return.

          Name: ____________________________________________

          Address:  __________________________________________

                          __________________________________________

                          __________________________________________

          Country: ___________________________________________

          Telephone Number (daytime): ___________________________

          Telephone Number (evening): ___________________________

          Email Address:_______________________________________

          Order Number: ______________________________________

          Reason: ____________________________________________

                        ____________________________________________

                        ____________________________________________

          Please Sign: ______________________________     Date: _____________

                        Send To:    Marquis Gold Co.

                                         Attention: Customer Return

                                         650 South Hill Street #C5

                                         Los Angeles, CA 90014-1783