ON – Missing or Damaged Cookie Cases Report – Receivers Before completing this form, please ensure that: You are an active Cookie Receiver You are reporting missing/damaged cases from the current cookie campaign You are completing this form no later than 2 days after your delivery date You are able to provide a copy of your POD (Proof of Delivery) showing that the missing/ damaged cases were reported to the driver at the time of delivery** Please complete all fields below and submit the form. Upon submission, a report will be sent to the Cookie Coordinator, who will share your report of missing/damaged cases with our National Office, to see if replacement cases or a credit can be received. You will be contacted by the Cookie Coordinator after your report has been reviewed and next steps have been confirmed by the National Office (for example, if replacement cases will be delivered).Name* First Last Phone*Email* Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Community #*N/AProvincial13456789101314151617181921222324252728293031323435363738404199Number of cases affected*Please select one that applies to your incident*MissingDamagedDate of delivery* MM slash DD slash YYYY Summary of issue* Was this noted on the POD (Proof of deliver)?* Yes No Please upload a copy of the POD* Drop files here or Select files Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 8 MB. Were replacement cases provided at the time of delivery?* Yes No Picture of damaged case(s), if available Drop files here or Select files Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 8 MB. CAPTCHA