2020 GOLD SHIELD BANKNOTE AUTHENTICATION
AND GRADING APPLICATION FORM

 

(Please use one application form per submission).
 
TYPES OF SERVICE: (Please choose one service per submission form Max 20 banknotes per submission)

 

Raw Banknote: (A Banknote that is not currently in any grading service holder and will be certified, graded and slabbed in one of the
following service options highlighted below. Please choose from one of the following services:

 

__ANY INDIVIDUAL BANKNOTE_____________________________________________________________
□ Modern Economy Service (Banknote value up to £240 / €300) Price: £27.95 Each
      (For any Modern Banknote dated 1961 to Present Max value £240/€300 each Minimum 5 Banknotes)
□ Economy Service (Banknote value up to £240 / €300) Price: £39.95 Each
      (For any Banknote Any Date Max Value £240 / €300 each)
□ Regular Service (Banknote value up to £2,100 / €2,500) Price: £59.95 Each
      (For any Banknote Any Date Max Value £2,100 / €2,500 each)
□ Premium Service (Banknote value up to £8,200 / €10,000) Price: £109.95 Each
      (For any Banknote Any Date Max Value £8,200 / €10,000 each)
□ High Value Service (Banknote value up to £20,000 / €25,000) Price: £209.95 Each
      (For any Banknote Any Date Max Value £20,000 / €25,000 each)
□ Rarity Service (Banknote Value Unlimited) Price: £299.95 Each + 2% of value
      (Any Banknote Any Date Unlimited Value)
□ Special Service (Price below + Grading Fee)
      (For any Banknote with Errors, Specimen or Proof Banknotes Max Value £750 each)
    (Banknote value up to £750 / €1,000) Price: £25.00 Each / (Banknote value up to £2,200 / €3,000) Price: £35.00 Each 
    (Banknote value up to £14,750 / €20,000) Price: £55.00 Each / (Banknote value up to £75,000 / €100,000) Price: £85.00 Each 

 

(For banknotes that require the use of an oversized holder larger than 19.50cm x 21.00cm there will be an additional charge see below under Additional Services)
(For Errors, Specimens and proof banknotes must be submitted at the Economy Special Service or Higher)

 

___BULK BANKNOTES____________________________________________________________________________________________________________
□ Modern Economy Service (Banknote values £0 / €0 up to £240 / €300) Price: Call For Price
      (For any Modern Banknote dated 1961 to Present Max value £240 each) Minimum 50 Banknotes
□ Economy Service (Coin values £0 / €0 up to £240 / €300) Price: Call For Price
      (For any Banknote Any Date Max Value £240 each) Minimum 50 Banknotes
□ Regular Service (Coin values £240 / €300 up to £2,100 / €2500) Price: Call For Price
      (For any Banknote Any Date Max Value £2,100 each) Minimum 50 Banknotes

 

___ADDITIONAL SERVICES____________________________________________________________________________________________________
□ Oversized Holder (Banknotes that require an oversized holder larger than 19.5cm x 21.00cm) Price: £19.95 Each
     (Price is in addition to Grading Fee)

 

 

___ BANKNOTE ACCESSORIES________________________________________________________________________________________________
□ Banknote Myler Sleeves (Perfect for grading submissions and storage of your banknotes - Pack of 25) Price: £17.95

 

___PCGS GOLD SHIELD RE-HOLDER_________________________________________________________
Re-Holder (Banknotes which are currently in PCGS Gold Shield holder placed in a new holder at the same grade.)
□ Banknote up to £7,500 (£16.00 Each) □ Banknote Unlimited Value (£25.00 Each)
_____________________________________________________________________________________________

 

 

 

Coin Entry: (Max 20 Banknotes per Application Form per Individual Service chosen from above)


The London Coin Company Ltd, P.O. Box 495, Stanmore, Greater London, HA7 9HS, United Kingdom. 
UK Freephone: 0800 085 2933 / Int Phone: + 44 208 905 4624 - Reg No: 6428236 / VAT No: 931911533 
Email: sales@thelondoncoincompany.com / Web: www.thelondondoincompany.com

 

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Quantity Description Declared Value* Catalogue Serial/Pedigree
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_______ __________________________________ ___________ _________ ____________

 

If a proper catalogue number is not provided a £5 fee will apply per banknote. If a Serial Number/Pedigree is added a £5 fee will apply per banknote
(*Please be honest with your declared values as the grading division at The London Coin Company Ltd and PCGS Gold Shield Grading will be
inspecting them when they arrive and will also be used for insurance purposes, any item undervalued the appropriate charges will be added with
a 50% service fee surcharge by PCGS.)

 

RETURN SHIPPING & INSURANCE COSTS (Shipping and Insurance costs returning banknotes to customer, when
shipping banknotes to TLCC we recommend for the customer to use Registered Mail as the London Coin Company Ltd can not be held
responsible for any loss or damage so please pack safely and securely.)

 

 

UNITED KINGDOM CUSTOMERS:
◊ 1-10 BANKNOTES (Total Value from £0 - £500) Price £29.99
◊ 1-10 BANKNOTES (Total Value from £500 - £1,000) Price £44.99
◊ 1-10 BANKNOTES (Total Value from £1,000 - £2,500) Price £59.99
   For Each Additional £1,000 above £2,500 please add £22.50 per £1,000

 

◊ 11-20 BANKNOTES (Total Value from £0 - £500) Price £44.99
◊ 11-20 BANKNOTES (Total Value from £500 - £1,000) Price £59.99
◊ 11-20 BANKNOTES (Total Value from £1,000 - £2,500) Price £79.99
   For Each Additional £1,000 above £2,500 please add £22.50 per £1,000

 

◊ 21-30 BANKNOTES (Total Value from £0 - £500) Price £59.99
◊ 21-30 BANKNOTES (Total Value from £500 - £1,000) Price £79.99
◊ 21-30 BANKNOTES (Total Value from £1,000 - £2,500) Price £99.99
   For Each Additional £1,000 above £2,500 please add £22.50 per £1,000
◊ 30+ BANKNOTES OR TOTAL VALUE OVER £15,000 CONTACT FOR PRICES

 

DROP OFF &  COLLECTION: (Only available for customers looking to grade a minimum of 100+ Banknotes, or Banknotes
 with a value of £5,000 or more, please contact us for a price and to make an arrangement)

 

INTERNATIONAL CUSTOMERS: (Any Customs fees upon receiving your goods into the United Kingdom will be covered
by the buyer and added to the invoice, only applies to non-European customers)

 

◊ 1-10 BANKNOTES (Total Value from £0 - £500) Price £49.95 


The London Coin Company Ltd, P.O. Box 495, Stanmore, Greater London, HA7 9HS, United Kingdom. 
UK Freephone: 0800 085 2933 / Int Phone: + 44 208 905 4624 - Reg No: 6428236 / VAT No: 931911533 
Email: sales@thelondoncoincompany.com / Web: www.thelondondoincompany.com

 

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◊ 1-10 BANKNOTES (Total Value from £500 - £1,000) Price £69.99
◊ 1-10 BANKNOTES (Total Value from £1,000 - £2,500) Price £89.95
   For Each Additional £1,000 above £2,500 please add £22.50 per £1,000

 

◊ 11-20 BANKNOTES (Total Value from £0 - £500) Price £69.99
◊ 11-20 BANKNOTES (Total Value from £500 - £1,000) Price £89.99
◊ 11-20 BANKNOTES (Total Value from £1,000 - £2,500) Price £109.99
   For Each Additional £1,000 above £2,500 please add £22.50 per £1,000

 

◊ 21-30 BANKNOTES (Total Value from £0 - £500) Price £109.99
◊ 21-30 BANKNOTES (Total Value from £500 - £1,000) Price £129.99
◊ 21-30 BANKNOTES (Total Value from £1,000 - £2,500) Price £149.99
   For Each Additional £1,000 above £2,500 please add £22.50 per £1,000
◊ 30+ BANKNOTES OR TOTAL VALUE OVER £15,000 CONTACT FOR PRICES

 

OUR SHIPPING ADDRESS: (Address used for the customer to ship there banknotes to us by Royal Mail Special
Delivery, please make sure you include the original of this signed application form, if using a courier or any other service
please email for alternative address.)

 

LCC Ltd 
P. O. Box 495
Stanmore
Greater London 
HA7 9HS
United Kingdom

 

CUSTOMER SHIPPING ADDRESS & CONTACT DETAILS: (This address will be used to return the
banknotes)

 

Customer Name: _________________________________
Phone: _________________________________________
E-mail: _________________________________________
Address 1: ______________________________________
Address 2: ______________________________________
Address 3: ______________________________________
County: ________________________________________
City/State: ______________________________________
Postcode: _______________________________________
Country: ________________________________________

 

TOTAL COSTS: (Please Indicate the Currency you prefer to be Invoiced In)

 

Banknote Quantity: _______________
Service Value: £ ______________
Additional Services: £ ______________
Submission Fee: £15.00 _________ Per Individual Service Per 20 Banknotes
Shipping / Drop Off Charge: £ _____________
Total: £ ____________________
VAT 20%: £ ________________

 

GRAND TOTAL: £ ________________

 


The London Coin Company Ltd, P.O. Box 495, Stanmore, Greater London, HA7 9HS, United Kingdom. 
UK Freephone: 0800 085 2933 / Int Phone: + 44 208 905 4624 - Reg No: 6428236 / VAT No: 931911533 
Email: sales@thelondoncoincompany.com / Web: www.thelondondoincompany.com

 

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Name of Customer: ______________________Signature:_________________ Date:___________

 

Please send original signed copy of this application with your banknotes and please keep a copy.

 

Office Use:
Number of Coins Received____________________ Payment Received:_________________________________

 

Chosen Service_______________________________ Total Value:_____________________________________

 

GOLD SHIELD SUBMISSION INSTRUCTIONS

 

Please read carefully. Following these directions will help expedite your
order. 
1. Please print your Name, legal address, email address, and phone number in
the spaces provided. 
2. Grading fees shown excludes VAT.
3. Package Information (required) – Please provide the total number of orders
in the package. If this is the only order you are submitting, the number
should be one. 
3. Select the Type of Submission. ONLY ONE TYPE OF SUBMISSION AT
ONE SERVICE LEVEL IS PERMITTED PER SUBMISSION FORM.
DEFINITIONS
GRADING: For banknotes not encapsulated or graded by
any grading service. 
REGRADE: For banknotes previously certified by PCGS/TLCC Gold Shield
Grading that you feel might be worthy of a higher grade. Submit the banknotes
in the PCGS/TLCC Grading holder. 
Banknotes submitted under the regrade service will be removed from the holder
and regraded. If the banknote grades lower, the terms of the PCGS/TLCC Gold
Shield Grading guarantee will apply. 
REHOLDER: For the re-encapsulation of PCGS/TLCC Gold Shield Grading
certified. Any banknote submitted under the reholder service will not be
regraded. GRADING OPTIONS: Please select “Standard” to have your
banknotes graded numerically or select “Genuine only” for authentication only.
Currently PCGS Gold Shield Grading does not offer the Crossover service.
Banknotes certified by other third-party grading companies that are submitted to
PCGS/TLCC Gold Shield Grading, will be removed from their existing holder
and graded as raw. 
4. Select the Service Level by referring to the PCGS/TLCC Gold Shield Grading
Services and Fees. Please note the minimum requirements and restrictions within
each service level. 
5. List the details for each banknote in the following area. • Quantity – List the
total number of banknotes (per line). If you have multiple of the same banknote,
you can list them on the same line. • Country – List the Country where the
banknote was issued. • Catalog # - Provide the catalog number for each
banknote. • Date/Series – List the date or series of the banknote. • Denomination

– List the denomination of the banknote. • Type – List the type of banknote here
(if applicable). • Serial Number and Pedigree – Notate the serial number and any
pedigree requests. For multiple notes with consecutive serial numbers, list the
range of numbers. All Pedigree requests must be pre-approved. • Oversized
Holder – For banknotes that require the use of an oversized holder (larger than
19.5cm x 21cm), there is an additional fee of 10€ per banknote. Select the option
in this area. • Declared Value – Each banknote requires a declared value (per
banknote). List the assigned value for each banknote in this area. NOTE: This
value must coincide with the selected service level (from Section B). • Subtotals
– Calculate the subtotals for each column and list in this area (Oversized Holder
Fee and Declared Value). 
6. Fee Calculation. List the number of banknotes multiplied by the service level
fee and total on this line. 
7. Additional Fee. If banknotes require the use of an oversized holder, calculate
the totals and list the fee (where applicable). 
9. Total Charges must be paid 5 days from invoice. 
10. Method of Payment. The following options are accepted: Cash, Bank Wire
Transfer, Debit Card, Paypal with Fee or Credit Card with Fee.  
11. Read Terms and Conditions. Sign and date at the bottom of the form to
accept the PCGS/TLCC Gold Shield Grading Terms & Conditions (located
below). Order will not be processed without signature. Keep a copy for your
records. 
12. Place each banknote in a new mylar sleeve (only one banknote per sleeve).
Do not send banknotes with staples. Package banknotes and submission form
carefully. 
13. Submissions can either be delivered in person for orders of 40 Banknotes or
value £5,000 upwards please contact us for more information (by appointment
only) or shipped directly to us. Mail all banknote submissions to TLCC
Submission, P.O. Box 495, Greater London, HA7 9HS, United Kingdom. 
Note: All terms and conditions are subject to change. Estimated turnaround times
do not include mailing time and reflect business days. IF MORE THAN ONE
TYPE OF SUBMISSION OR SERVICE LEVEL IS INCLUDED ON ANY
ONE FORM, YOU AUTHORIZE PCGS/TLCC BANKNOTE GRADING TO
SEPARATE THE ORDER FOR PROCESSING AND AGREE TO PAY ANY
ADDITIONAL GRADING FEES THAT MAY APPLY.

 

PCGS/TLCC GOLD SHIELD GRADING TERMS & CONDITIONS

 
By signing the front side of this form, Customer
acknowledges that they have read the PCGS/TLCC
Gold Shield Grading (“PCGS Gold Shield
Grading”) Terms and Conditions (the “Agreement”)
set forth below and agrees to abide by this
Agreement, and further agrees that PCGS/TLCC
Gold Shield Grading is entitled to rely upon and
benefit from this Agreement. 1. PCGS/TLCC Gold
Shield Grading will endeavour to grade banknotes
within the time frame, if any, offered as part of a
PCGS/TLCC Gold Shield Grading service.
However, PCGS/TLCC Gold Shield Grading will
have no liability whatsoever to Customer for
incidental or consequential damages due to
PCGS/TLCC Gold Shield Grading’s failure to grade
any banknote within any time frame. All days are
business days. 2. PCGS/TLCC Gold Shield Grading
will not grade banknotes that appear to be
significantly altered or are of questionable
authenticity. If PCGS/TLCC Gold Shield Grading
rejects any banknote for grading in accordance with
PCGS/TLCC Gold Shield Grading’s grading
standards and procedures, PCGS/TLCC Gold Shield
Grading shall not refund the fee paid by Customer.
Customer represents and warrants that they has no
knowledge and no reasonable basis to believe that

any banknote submitted for grading has been altered
or Doctored in any way. For purposes of this
Agreement, “Doctored” shall have the meaning set
forth in the applicable PCGS/TLCC Gold Shield
Authorized Dealer Agreement or PCGS/TLCC
Collectors Club Agreement by and between
Customer and PCGS/TLCC (the “Customer
Agreement”). Customer warrants that all
information provided herein is accurate and reliable
and undertakes to promptly correct and update such
information if Customer discovers any such
information is inaccurate. 3. Grading involves
individual judgments that are subjective and require
the exercise of professional opinion, which can
change from time to time. Therefore, PCGS/TLCC
Gold Shield Grading makes no warranty or
representation and shall have no liability
whatsoever to Customer for the grade assigned by
PCGS/TLCC Gold Shield Grading. 4. PCGS/TLCC
Gold Shield Grading will exercise reasonable care
in Packaging banknotes submitted for grading,
regrading or re-holdering. However, if PCGS/TLCC
Gold Shield Grading determines that the
Customer’s banknote was lost or damaged while in
PCGS/TLCC Gold Shield Grading possession,
Customer will be compensated based upon the fair

market value of the banknote as determined by
PCGS/TLCC Gold Shield Grading standard
procedures which may include filing a claim with
our insurance carrier. The declared value you stated
on the front of this form is for estimating the
insurance coverage only, and the fair market value
of the banknote may be less than your declared
value. IN NO EVENT SHALL THE TOTAL
LIABILITY EXCEED THE DECLARED VALUE
OF THE BANKNOTE. 5. Customer must inspect
all banknotes immediately upon receipt and
PCGS/TLCC Gold Shield Grading disclaims any
liability for damage or discrepancies or errors,
including but not limited to errors in the description
of the banknote, unless reported to PCGS/TLCC
Gold Shield Grading within five (5) days of
Customer’s receipt of the banknote(s). Customer
agrees to return any incorrectly described banknote
to PCGS/TLCC Gold Shield Grading upon request
for correction and agrees to indemnify and hold
PCGS/TLCC Grading harmless from any and all
losses and/or claims caused by the circulation or
sale of any incorrectly described banknote. 6.
Customer agrees (a) to pay to PCGS/TLCC Gold
Shield Grading all fees and other charges when due;
(b) that all fees are exclusive of local taxes; (c) that


The London Coin Company Ltd, P.O. Box 495, Stanmore, Greater London, HA7 9HS, United Kingdom. 
UK Freephone: 0800 085 2933 / Int Phone: + 44 208 905 4624 - Reg No: 6428236 / VAT No: 931911533 
Email: sales@thelondoncoincompany.com / Web: www.thelondondoincompany.com

 

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any delinquent balances shall accrue interest at the
rate of 10% per year until paid (or, if less, the
maximum interest rate permitted by applicable law);
and (d) that PCGS/TLCC Gold Shield Grading shall
have a security interest in the banknotes submitted,
as well as in any other property of Customer in the
possession of PCGS/TLCC Gold Shield Grading or
its affiliates (collectively, the “Property”), to secure
payment thereof. Customer hereby grants to
PCGS/TLCC Gold Shield Grading an assignment of
and lien against the Property in the amount of any
fees and other charges due and payable pursuant to
the terms of this Agreement. Customer hereby
authorizes PCGS/TLCC Gold Shield Grading to
file, at any time on or after the date such fees and
other charges become due, appropriate uniform
commercial code financing statements in such
jurisdictions and offices as PCGS/TLCC Gold
Shield Grading deems necessary in connection with
the perfection of a security interest in the Property.
7. PCGS/TLCC Gold Shield Grading shall have no
liability whatsoever to Customer, or any third party
for whom Customer may be acting, for (i) any
personal injury or (ii) for any damage to any
banknote, or otherwise, that Customer is unable to
demonstrate was attributable primarily to an act or
omission to act by PCGS/TLCC Gold Shield
Grading while the banknote was in its possession
and control, except for any damage to a banknote
resulting from the breaking open by PCGS/TLCC
Gold Shield Grading of a PCGS/TLCC Gold Shield
Grading or other banknote holder in which the
banknote may have been submitted for grading to
PCGS/TLCC Gold Shield Grading. 8. Note all
terms and conditions are subject to change.
Turnaround times do not include mailing time and
reflect business days. 9. Except as expressly set
forth herein to the contrary, PCGS/TLCC Gold
Shield Grading DISCLAIMS ANY AND ALL W A
R R A N T I E S , E X P R E S S E D O R I M P L I
E D , REGARDING PCGS/TLCC GOLD SHIELD
GRADING’S GOODS AND SERVICES,
INCLUDING BUT NOT LIMITED TO THE
WARRANTIES OF MERCHANTABILITY AND
FITNESS FOR A PARTICULAR PURPOSE. 10.
Notwithstanding anything to the contrary contained
herein, except with respect to the remedies under
the PCGS/TLCC Gold Shield Grading Guarantee of
Grade and Authenticity set (the “Guarantee”) and as
set out in paragraph 4 above in connection with the
loss or damage to a banknote while in the
possession of PCGS/TLCC GOLD SHIELD
Grading THE MAXIMUM AGGREGATE
LIABILITY THAT PCGS/TLCC GOLD SHIELD
GRADING SHALL HAVE TO CUSTOMER, OR
ANY THIRD PARTY FOR WHOM THE
CUSTOMER MAY BE ACTING, ARISING
FROM ANY CAUSE, ACT, OMISSION OR
OTHER CIRCUMSTANCE, SHALL IN NO
EVENT EXCEED THE GRADING FEE OR
AMOUNT ACTUALLY PAID BY CUSTOMER
FOR THE GRADING SERVICES RENDERED
BY PCGS/TLCC GOLD SHIELD GRADING
WITH RESPECT TO THE B A N K N O T E S S U
B M I T T E D F O R G R A D I N G
HEREUNDER. IN NO EVENT SHALL
PCGS/TLCC GOLD SHIELD GRADING OR
ANY OF ITS AFFILIATES, OR ANY OF ITS OR
THEIR RESPECTIVE EMPLOYEES, OFFICERS,
DIRECTORS OR AGENTS, BE LIABLE TO
CUSTOMER OR ANY OTHER PARTY FOR
ANY I N D I R E C T , I N C I D E N T A L , S P E
C I A L , CONSEQUENTIAL OR EXEMPLARY
DAMAGES, EVEN IF ADVISED OF THE
POSSIBILITY OF SUCH DAMAGES. 11. In the
ordinary course of its grading operations,
PCGS/TLCC Gold Shield Grading (i) compiles data
regarding each banknote submitted for grading,
including, but not limited to, data relating to the
identity, minting, condition and grade of the