Trust Pay Claim Undertaking Form

1) To whom was the shipment delivered?

Self
Family Member
Neighbour
Security Guard
Any Other __________________________________

2) Condition of Outer package (Polybag/Carton) at the time of delivery?

(a) Was the Outer packaging (Polybag/Carton) intact at the time of delivery?
Yes
No
(b) If No, then please let us know the issues in packaging?
Outer/ safety packaging having snapdeal mark/ logo were missing.
Cut mark on the packing.
Any other type of tape (apart from Snapdeal) was found on the packaging.
Packaging was already opened.
Packaging was damaged.
Any other __________________________________________

3) Was the inner (Brand Box) packet intact before opening the box?

Yes
No

(a) If No, then please select to let us know the issues in Inner (Brand box) packaging?
Brand Box was damaged.
Cut mark on Brand Box.
Cut mark on the seal.
Seal was tampered.

4) Any other Remarks/Feedback?

__________________________________________________________________________

UNDERTAKING

Dear Sir,
I, Mr/Miss/Ms_____________________ S/o/D/o/W/o ________________________ R/o
________________________ _ hereby confirm/undertake:
▪ I had ordered ______________________ (Product Name) listed on Snapdeal.com on ____________ (Date) order
no. ____________.
▪ Subsequent to such order, I had received a package on ____________ (date of receipt) from seller ________
(seller name/ code) containing ____________________.

I will support with any additional information as may be required. The information given above is true and correct. I hereby
make myself liable for all the costs, consequences, legal action and proceedings if any happens due to my misstatement or
misrepresentation or suppression of facts in connection with the above undertaking and the same is found / established or
proved by any authority / entity including the Jasper Infotech Pvt Ltd and/ or the seller/ brand at any subsequent stage.

Place:
Date: Customer Signature