CERTIFICATE OF NON-RECEIPT
Instructions: Please complete and return this form within 30 calendar days after the order shipment date if your US Coin Trust order did not arrive, or arrived with missing products.
Order #: ___________________________
Customer Name:_________________________________________________________________________ Customer Address: _______________________________________________________________________ Telephone (Day) ___________________ (Evening) __________________ (Mobile) ____________________
Description of Missing Item(s):
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
Quantity Ordered ________ Quantity Received________ Quantity Missing ________
Check the statement which best describes your complaint:
______ Order was not received at all ______ Package arrived without coins ______ Package arrived with 1 or more coins missing ______ Disregard claim (package arrived)
Did your package arrive damaged? Please explain the condition.
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
Have there been any recent changes to your account information? Please explain.
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
Comments:
____________________________________________________________________________________________________________________________________________________
Signature: ____________________________________ Date: ______________________
Please allow up to 6 weeks for review and processing. Please mail this form to the following address below.
US Coin Trust
ATTN: CSC
1719 NJ-35, STE 2, Oakhurst, NJ 07755
E-mail: uscointrust@gmail.com
False official statements or claims are a violation of Federal Statute and are subject to prosecution. 12/2023