Product Support

Customer Information

First Name

Last Name

Phone 1 (###-###-####)

Phone 1 Type Home phone Primary cell phone Secondary cell phone Primary work phone Secondary work phone

Phone 2 (###-###-####)

Phone 2 Type Home phone Primary cell phone Secondary cell phone Primary work phone Secondary work phone

Email

Address

City

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Zip Code

Region Select a Region US Consumer Canadian Consumer Ireland Consumer Italy Consumer Unknown

Age Group Select Age Group 18-20 21 and over

Must be at least 18 or older to submit a product support claim with Winchester.

Incident Related Information

Date of Incident (mm/dd/yyyy)

Firearm Type Select a type of firearm Rimfire Handgun Rimfire Rifle Centerfire Handgun Centerfire Rifle Shotgun Unknown

Firearm Make Select firearm manufacturer REMINGTON GLOCK BROWNING RUGER WINCHESTER SMITH & WESSON SAVAGE MARLIN BERETTA BENELLI MOSSBERG TAURUS SIG THOMPSON/CENTER COLT SPRINGFIELD ARMORY H & R WALTHER ROSSI OTHER

Firearm Model

Firearm Serial No.

Ammunition Type Select a type of ammunition Centerfire Rifle Centerfire Handgun Shotshell Rimfire Rifle Rimfire Handgun Components

Ammunition Lot Number

Ammunition Qty. Purchased

Ammunition Price / Receipt

Ammunition Purchase Date (mm/dd/yyyy)

Complaint Type Select a type of complaint Damaged Gun Misfire Other Recall Split Brass Squib

Describe the nature of the complaint (400-character limit):

Please attach any documents of photos related to this complaint (max file size: 4MB):

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Attachment(2):

Attachment(3):

Attachment(4):

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