Mail-In Evaluation & Payout Form

By signing, I affirm under penalty of law that I am the lawful owner or authorized representative of the enclosed materials and that, to the best of my knowledge, they are not stolen property. I authorize Capital Gold LLC, doing business as American Fire Metals Recovery, to inspect, test, photograph, and weigh them for a purchase offer. I understand that testing may alter or consume a small portion of the material, that any estimate is provisional until evaluation is complete, and that no unapproved hazardous material is enclosed. Ownership transfers only after I accept the final offer. If accepted, payment will be issued by check.