Type of jewelry:
Age of jewelry:
Jewelry material:
Dominant stones:
Total weight (in grams):
Is this a designer piece?
If yes, who was the designer?

If applicable, please fill in your specifications on your center stone:
Diamond Shape:

Round Cut Diamonds
Princess-Cut Diamonds
Emerald-Cut Diamonds
Asscher-Cut Diamonds
Marquise-Cut Diamonds
Oval-Cut Diamonds
Radiant-Cut Diamonds
Pear-Cut Diamonds
Cushion-Cut Diamonds

What is the carat weight of the primary diamond?
Diamond color:
Diamond clarity:
Has the diamond been certified?
If yes, which lab certified it?
What is your certification #:

Overall Condition:
Additional Comments
(Coins, Pearls, Color Stones):



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First Name:
Last Name:
Address:
City:
State:
Zip Code:
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