Product Mart is committed to bringing you the prices you love. While very rare, some products get damaged and may become non-edible. With all health and safety rules set up by Jesstopia's Government, we ask that any damaged goods, be reported using the online form, or the form below. If you have any questions regarding the Damaged Goods Report Form, visit gov.jesstopia.org/report/damaged-goods
If you don't know some of the details, please place N/A.
Product Name UPC Qnty
Item Type(Select One)
[ ]Food Item
[ ] Snack Item
[ ]Clothing Item
[ ] Electronics Item
[ ] Glass Item
[ ] Other:__________
Date Item Was Damaged Signature Of Manager
Delivery Company Name Email
Phone Number Extensions(if applicable)
Address City State
Zip Code Town/City
Delivery Expected To Store #

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