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Service Questionnaire

STOP! Only complete this form if you need a written statement regarding authenticity or condition. Answer questions to the best of your ability. If this form malfunctions, please copy and paste the information into an email and send to claims @ mypoupette.com (remove spaces). Or, you may fax to us. Contact us for the fax number.

To open a claim with PayPal click here. When you are ready to request a third party opinion, complete the form on this page.

SERVICE QUESTIONNAIRE

Please be prepared to ship your item to My Poupette in Nevada or California. Some exceptions may apply.

How did you hear about My Poupette's Authentication Service?

 

1. What is the purpose of this request ?

2. What is your Case or Claim number, if applicable?

3. If we are faxing this letter to PayPal, eBay or another party on your behalf, provide the fax number and contact name:

4. Where did you purchase this item? 

5. What auction number?

6. Did you receive the same item pictured in the auction? Check date code or serial number, if available..

Yes

No

Uncertain

7. Your First Name:   Your Last Name:

8. Your Contact Phone Number(s) and best time to call:

9. Your Email Address:    Alternate e-mail address, if available:

10. Your Address:

11. What is the brand name on the item?

12. What is the name or style of the item?

13. What is the lining material, if you know?

1. Where does the item state it was made?

14. What color is the lining material, if you know?

15. Is there a date code or serial number? If so, what is it?

16. How did you pay for this item? (if applicable)

17. Amount Paid (exclude postage)

18. Seller's Name and Address, if known:

Seller's Email Address:

19. How long have you had possession of this item?

20. If this is an authenticity dispute, what are your reasons to believe the item may not be authentic?

21. Are you able to provide detailed photos of the item, if needed?

Yes

No

Check here if you have sent photos to us within the past 60 days.

22.  If you have had other opinions rendered on this item, by whom and what were the opinions?

23.  Do you need your statement/certificate sooner than 10 business days from time request is received by Poupette? (Do not include Weekends or Holidays) Remember: you cannot file a claim with eBay or Yahoo until after 30 days of auction close. Note this only applies to requests for written authentication. There is an additional charge for rush service.

Yes 

No  

24. If you have filed a claim, what is the exact DUE DATE for your statement? Do not subtract any days.

25. If this is for a claim or dispute, other than this request, what other steps, if any, have you taken to recover funds from this purchase?

26. Any other Comments or Instructions?

27. May we contact you in the future for feedback or on a related matter? We will not solicit you for sales.

Yes

No

28. ACKNOWLEDGMENT AND DISCLAIMER: By submitting this form, you acknowledge that you have read My Poupette’s Authentication Service Page, and that you agree to hold My Poupette harmless against any and all losses or claims that may arise from preparation or lack of preparation of the document you are requesting. We are not familiar with every item produced and will not render a written opinion if we are not at least 99% confident in our opinion. By engaging our services, you acknowledge that we will take every precaution and make every effort to render an accurate opinion, however opinions rendered may be subject to a small error margin. You agree to hold us harmless against any and all losses or claims that may arise from the preparation or lack of preparation of the document that you are requesting.

29. Check box to confirm that you need a written statement, and that you understand that your request is processed via business days. We may need to see your item in person. If this is the case we will advise you.

PLEASE DOUBLE CHECK YOUR E-MAIL ADDRESS! If it is wrong, we may not be able to reach you.

Please print this page in case of data transmission problems.

 

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Written Authentication Letter or Statement.