EmailMeForm
Order Duplicate Certificate of Authenticity
Please fill in all information. You will be charged $25.00 for each duplicate and can pay by Paypal (or credit card via paypal).
Contact Name
*
Name for revised or duplicate certificate of authenticity
*
Enter name you want on new certificate of authenticity
Company Name
*
Please enter the name as it appears on your existing certificate of authenticity
Phone Number
*
###
-
###
-
####
Email
*
Confirm email address
Barcode Number
*
Enter barcode number or first number in series. Enter numbers only - no spaces.
Number of barcodes covered by original certificate
*
Date of purchase
*
MM
/
DD
/
YYYY
Approx date okay.
File Upload (Optional)
Please attach your existing certificate of authenticity if available.
Image Verification
Please enter the text from the image:
[
Refresh Image
] [
What's This?
]
Total
$25.00