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2. Item Type

   1. Book
   2. Audiobook
   3. Video
4. Type of Damage

   1. Torn Page
   2. Disc Won't Play
   3. Writing on pages
   4. Other
6. First Name
7. Last Name
9. Library Card Number
   If available include the 14 digit card number the item is checked out to.
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11. 1. Receive an email copy of this form.
12. Email address

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13. Submit

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