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. Shipping Proof Estimated 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 recordAdditional 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
