New and Unused Item Declaration Form
Please complete this form to declare that your item is new and unused. All fields are required for verification and record purposes.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Item Type
*
Please Select
Electronics
Apparel
Household
Sporting Goods
Tools
Toys
Other
Brand / Manufacturer
*
Model Name or Number
*
Serial Number (if applicable)
Purchase Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Upload Proof of Purchase or Item Photo
*
Upload a File
Drag and drop files here
Choose a file
Cancel
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Declaration Statement
*
I declare that the item described above is new, unused, and in its original condition.
Submit Declaration
Should be Empty: