Claim Form

Instructions

  • Please keep a copy of this email for your records.
  • Please print this email and send it with your gold, platinum or coins to:

Falko’s

3 Queensgate centre

Orsett Road

Thurrock

RM17 5DF

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Your Contact Details

Title

Forename (required)

Surname (required)

Your Email (required)

Contact Telephone (no spaces):
Mobile:

Landline:

Your Address (required)

Description of the items you are sending Falkos Jewellers

Description: e.g. 9ct Bracelet - 20g 18ct Bracelet - unknown platinum ring - 5g

Approx total Value:

Do you have any messages for us?

Your Message

Optional Section

Media Source: Where did you hear about us?

What Made you choose FalkosGold?

Please Specify where appropriate:

Please sign and date to confirm

1. I am the legal owner or have the permission of the owner to sell these items.
2. I wish to sell the enclosed items to Falko’s Jewellers.
3. I agree to Falko’s Jewellers terms of service and privacy policy.

Signed:

Dated:

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