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Exchange Form

Please print out this form and fill out all fields

1. Exchange Authorization Number: _______________________
You can obtain this code by contacting Customer Service.
2. Your Information:

Name: ____________________________________________________________
Address: __________________________________________________________
__________________________________________________________________
__________________________________________________________________
E-mail Address: ____________________________________________________________
Telephone Number: ____________________________________________________________

3. Order Information
Order Number:_________________

Reason for Exchange
_____________________________________________________________________
_____________________________________________________________________

Exchange Address:

Goldia
509 E. 88th St. Suite: 3A
New York, NY 10128 USA

Please don't forget to write your Exchange Authorization Code on the outside of the package or we will not be able to accept your return.