Prize Handover Verification Form
Please complete this form to verify the proper handover of the prize to the recipient.
Recipient Full Name
*
First Name
Last Name
Recipient Email Address
*
example@example.com
Recipient Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Prize Description
*
Prize Serial Number or Reference (if applicable)
Date of Handover
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location of Handover
*
Name of Person Handing Over Prize
*
Condition of Prize at Handover
*
Please Select
New
Excellent
Good
Other
Recipient Signature (to confirm receipt of prize)
*
Submit Verification
Submit Verification
Should be Empty: