Item Value Collection Survey
Please provide details and your assessment of the value for each item listed. Your responses will help us better understand item characteristics and perceived worth.
Your Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Item Name
*
Item Category
*
Please Select
Electronics
Furniture
Jewelry
Collectibles
Artwork
Appliances
Other
Item Description
Estimated Value (USD)
*
Condition of the Item
*
Brand New
Like New
Good
Fair
Poor
Date of Acquisition
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How did you acquire this item?
Purchased new
Purchased used
Gift
Inherited
Other
Frequency of Use
Daily
Weekly
Monthly
Rarely
Never
Please rate the importance of this item to you
*
Not important
1
2
3
4
Extremely important
5
1 is Not important, 5 is Extremely important
Overall satisfaction with this item
1
2
3
4
5
Item Assessment Table
Rows
Appearance
Functionality
Durability
Excellent
1
2
3
Good
4
5
6
Average
7
8
9
Poor
10
11
12
Additional Comments or Notes
Submit Survey
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