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. 12/2021