Individual Coin Replacement Form

Fantasy Coin Missing/Damaged Items
How would you like to resolve the issue?

Refund for value of items Exchange item for something else Replace items with same ones if available Receive special or no longer produced items as a replacement. (example: gold/silver plated coins in capsules)
Please list all items (and thier quantities) that you are requesting to be replaced. Simple lists are best.

Example:

FC1-5 Fire Gold pack of 10 x 1

Fire Gold Coin x 2

Roman Copper Coin x 1
Item List
Full Name *

First Name Last Name
Shipping Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Email *
Comments
Should be Empty:

Fantasy Coin Missing/Damaged Items