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Topco Associates LLC

Name*
Street Address
City, State, ZIP Code
Email*
Phone
Your Message*
Product UPC #*

Product UPC = a 12 numerical digit code uniquely assigned to a retail product unit. An example image is shown below.
Product CSA*

Product CSA = Located near the toll-free number following the copyright symbol. It is typically four letters followed by 4 numbers.
Product Lot Code #*

The Product Lot Code typically appears near a product's expiration date on the product packaging. Please provide all the letters and numbers that you see. Examples are shown below.
Product Expiration Date*

If applicable, please provide any information about the product's expiration or best-by date from the product packaging.
Product Cost Amount (Dollars)*
Name of store where product was purchased

Please provide the complete name of the store where you purchased the product in question.
Fields with an asterisk (*) are required.
Phone
This field is for validation purposes and should be left unchanged.

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