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Opt-Out of Order Verification Form Download

There are four options for returning the executed form:

1. Mail to the following address:

14101 Southcross Drive West
Suite 175
Burnsville, MN 55337

2. Take a clear picture of the entire document using your Smart phone/tablet. Attach the picture and email to docs@moderncoinmart.com.
3. Scan it. Attach the scan and email it to docs@moderncoinmart.com.
4. Fax to 952-707-7505.

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