Precious metal Refining form
Name
*
First
Last
Contact E-mail
*
Pre-paid shipping label will be sent to this email
Phone Number
*
-
Area Code
Phone Number
Date
*
-
Month
-
Day
Year
Date Picker Icon
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Upload A Government Issued Photo ID
*
Browse Files
Cancel
of
What material(s) Will you be sending in?(check box if applicable)
*
Sending
Description
Gold Filled Material
Mixed Gold Scrap
Rings
Necklaces/Bracelets
Charms/Pendants
Earrings
Filings
Sweeps
Gold Bullion
Gold Coins
Sterling Silver
Mix Alloy Silver
Silver Bullion
Silver Coins
Platinum
Platinum Bullion
Palladium
Palladium Bullion
I hereby agree to the complete Terms and Conditions as found at ExoticElementsRefining.com. I declare I am at least 18 years of age, I am the lawful owner of the enclosed items with absolute authority to sell them, and my government issued personal identification number that i have included above and all other identifying information contained herein is true and correct. I declare under penalty of perjury that the foregoing is true and correct.
*
Referal code?
get up too $50 added to your payout
Payment
*
Check by mail (Free)
ACH
Paypal
Wire ($35 fee)
PayPal email (If Applicable)
ACH Routing number
Routing #
ACH Bank Account Number
Account #
(If Applicable)
Submit
Should be Empty: