Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Claim Information Date *Order # *Select Carrier *--- Select Choice ---UPSUSPSTracking #Customer Information Name *FirstLastEmail *Shipping Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhonePackage Status What Issue Occurred? *--- Select Choice ---Package LostPackage DamagedPackage Missing ContentsDelivered to the Wrong AddressOtherPlease Describe *Do You have the Package Now *--- Select Choice ---YesNoItem Information How Many Items in Your Order Were Affected?123456789 Repeater Card/Name *Quantity *Value *GradePlease indicate whether the card is graded or Raw. If Graded, please enter the Grader as well. Example: PSA 9 Estimated Total Damage *Please enter the Estimated Total Damage in Dollars ($) Please note that your Claims Representative will discuss the value of the damaged or lost items and this number is just an estimate. Please Describe Any Damage *If not applicable please enter N/ACondition of Shipping Box *--- Select Choice ---No Visible DamageTornWetOpenedCrushedNever ReceivedCondition of Item(s) *--- Select Choice ---Minor DamageModerate DamageSevere DamageTotal LossRequired Information Upload Photos Package Exterior * Drag & Drop Files, Choose Files to Upload You can upload up to 6 files. Upload clear photos showing: 1.) Shipping label 2.) Entire package 3.) Visible damage.Package Interior * Drag & Drop Files, Choose Files to Upload You can upload up to 6 files. Upload clear photos showing: 1.) Packing materials 2.) Protection used 3.) Package contentsDamaged Items * Drag & Drop Files, Choose Files to Upload You can upload up to 50 files. Upload clear photos showing: 1.) Front 2.) Back 3.) Close-upProof of Value * Drag & Drop Files, Choose Files to Upload You can upload up to 10 files. Upload one or more: 1.) Purchase receipt 2.) Invoice 3.) Auction invoice 4.) Marketplace sale record 5.)eBay sale record Layout Describe # Additional InformationPlease provide any additional details. The more information you can add will help in determining your claim amount.Resolution Requested *--- Select Choice ---Full ReimbursementPartial ReimbursementReplacement Item (if available)Store CreditAcknowledgement I certify that the information provided is accurate and complete. I understand that false claims may result in denial of reimbursement and suspension of marketplace privileges. Signature * Clear Signature Date *Submit
