Container Item Submission Form
Please fill in this form each time you buy an item and wish it to go into the container from CoinOp Warehouse.
DO NOT fill in this form if the item is not at CoinOp Warehouse or CoinOp Amusements and you're waiting for it to arrive - we do not need to know about anything that is in transit.
Please fill in this form per-item, if you have bought multiple items, you will need to fill the form in as many times as the number of items you have bought.
What type of item is this?
Standard Upright Sized Arcade Game - approx 65cm x 85cm (1 space)
Cocktail table game (1 space)
Cockpit game in single player form - approx 65cm x 170cm (2 spaces)
Twin sit-down game (SEGA Rally / Daytona type) (4 spaces)
Deluxe moving cockpit (OutRun, Afterburner etc) (6 spaces)
Small package (fixed handling fee)
Name of item
Date of purchase (approximately)
Purchase value in USD
Would you like us to perform any of the following services when it arrives in the UK
Power conversion to UK 240v
Monitor repair (subject to type)
PCB repair (subject to appraisal)
Cosmetic repair / restoration
Long term storage (per space per week cost, sliding scale based on duration)
Link to online sale page (optional) - this helps us identify multiple items later down the line.
Any other info about this item that describes it
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This form was created inside of JB Consultancy.