Consumer affidavit

STATE OF FLORIDA OFFICE OF THE ATTORNEY GENERAL PAM BONDI IN RE: INVICTA WATCH COMPANY OF AMERICA, INC. L14-3-1092 PLEASE COMPLETE AND RETURN SIGNED AFFIDAVIT TO: By mail:

Office of the Attorney General, Consumer Protection Division, 110 SE 6th Street, 9th Floor, Fort Lauderdale, FL 33301

By email:

FTL.EC@myfloridalegal.com

CONSUMER AFFIDAVIT NAME (Mr./Mrs./Ms.) _____________________________________ DATE OF BIRTH _________________ (Print or type name)

ADDRESS:

_____________________________________________________________ _____________________________________________________________ _____________________________________________________________

DAYTIME TELEPHONE: _________________________________ ( Home / Work / Mobile ) EVENING TELEPHONE: _________________________________ ( Home / Work / Mobile ) E-MAIL: _________________________________________________ Please specify:

Are you 60 years old or older?

_____ Yes _____ No

Are you disabled?

_____ Yes _____ No

Are you in the military?

_____ Yes _____ No

And who, after being sworn and deposed, upon his/her personal knowledge states: I would like to file a complaint against: ______________________________________________________________________________________________ ______________________________________________________________________________________________ (Please include: person/ company name, address and telephone number) 1. Did you purchase an Invicta watch from this company, online or from another retailer?

Yes ____ / No ____ If yes, on what date _______________ Where did you purchase the watch? ________________________________________

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In re: Invicta Watch Company of America, Inc. L14-3-1092

Consumer Affidavit Continued

2. When the watch was received, was it in good condition? Yes ____ / No ____ If no, please explain______________________________________________________________ _______________________________________________________________________________ 3. Did your watch come with a warranty? Yes ____ / No ____ 4. Did you purchase an extended warranty? Yes ____ / No ____ 5. Did you register the warranty? Yes ____ / No ____ If yes, on what date _______________ 6. Did you attempt to obtain service or repair of your watch from this company? Yes ____ / No ____ If yes, on what date _______________ What was the service or repair you wished to obtain?_______________________________________ 7. What was the cost that you paid for service or repair? $___________________.

8. What was your understanding of the length of time for service/repair and from where did you get that understanding? _____________________________________________________________________________________ _____________________________________________________________________________________ 9. How long did service/repair take? _________________.

10. Was it your understanding that the service or repair would be covered under warranty?

Yes ____ / No ____ 11. Were you told that the watch or any part of the watch had been discontinued? Yes ____ / No ____ 12. Was your watch repaired ___, replaced ___, or returned unrepaired ___? (Please check one.)

Please explain_________________________________________________________________________ _____________________________________________________________________________________ If your watch was returned unrepaired, did you receive a refund of the fee you paid for service?

Yes ____ / No ____ If your watch was returned unrepaired, were you offered a replacement watch?

Yes ____ / No ____ 13. If you were offered a replacement watch, please explain what the process was to obtain the replacement, if you received the replacement, and if you were satisfied with the quality of the replacement_____________________________________________________________________________

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In re: Invicta Watch Company of America, Inc. L14-3-1092

Consumer Affidavit Continued

________________________________________________________________________________________ 14. Please describe in detail the service that you received. Please include details about any services that were requested, promises made, and what services were ultimately completed. ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ 15. Did you contact Invicta Watch Company of America, Inc. to discuss your complaint? Yes ___ / No ___ If yes, describe in detail the names of persons you contacted, any response that you received or any actions that you took in an attempt to resolve your complaint: _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ 16. Clearly and in detail, please state your complaint below. a. Describe events in the order in which they occurred. b. Include dates, times, and names of individuals you communicated with. c. Provide a detailed description of the goods, products, or services you purchased, or for which you were solicited. d. Describe in as much detail as possible any statements or representations made to you regarding the goods, products, or services you purchased, or for which you were solicited. e. Describe in detail any differences between the goods, products, or services that were advertised, and any final goods, products or services that you received, if any such discrepancies did exist. f. You may attach additional pages to the back of this affidavit if necessary. _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ Page 3 of 4

In re: Invicta Watch Company of America, Inc. L14-3-1092

Consumer Affidavit Continued

17. I have paid $________________ to ________________________________________________________ (Exact name where payment was sent or that appears on any billing statement)

in the form of (check, money order, cash, credit card, etc.) _______________________________ IMPORTANT: Please attach COPIES of billing statements, receipts, or the front and back of any cancelled checks showing proof of payment. You may redact your personal account information.

18. I have received a FULL or PARTIAL refund in the amount of $ ___________________________ (Circle One) from ________________________________________________________________________________ (The entity that this affidavit complaint identifies, a successful dispute with your credit card company, or state any other means.)

(Please attach COPIES of receipt, front and back of refund check, statement showing refunded amount, etc.)

19. Please list below and attach any documents in support of your complaint. By signing below, you are certifying that these documents are true and correct copies of the originals.

(Please refer to the instruction sheet to ensure you have enclosed all necessary documents) ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Any attachments are hereby incorporated within and made part of this complaint affidavit.

Any copies attached are true and correct copies of the original.

FURTHER AFFIANT SAYETH NAUGHT. My signature authorizes the Attorney General's Office to take any action deemed necessary for purposes of investigation or enforcement. I understand that the Attorney General does not represent private citizens seeking the return of their money or other personal remedies. I am filing this complaint to notify your office of the activities of this company so that it may be determined if law enforcement or legal action is warranted.

Pursuant to Florida Statutes Section 92.525, under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true and correct and that I have personal knowledge of the facts stated herein. Pursuant to 28 U.S.C. Section 1746, I declare under penalty of perjury that the foregoing is true and correct. By typing my name in the signature field below, I hereby affirm and manifest my intent to authenticate this writing as authorized by the Electronic Signature Act of 1966, Florida Statutes, Chapter 668, Part I. Signed:

Dated:

IMPORTANT: Please be sure to sign on the line above and attach any relevant documents. Thank you in advance for your submission.

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