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Authentication Request

If you are purchasing a Canadian diamond from a Code Signatory member you need a polished diamond certificate/report and a receipt and then you can complete the form below.

If you would prefer manually filling out the form and mailing it, please click here to download the Authentication Request Form and once completed, you can mail the completed form to:
 
Canadian Diamond Code Committee
27 Queen Street East, Suite 600
Toronto, Ontario
M5C 2M6

Consumer Name*

Mailing Address*

City*

Province/State*

Postal/Zip Code*

Country*

Email*

Phone*

Fax

Information Required for Authentication

Retailer Name*

Mailing Address*

City*

Province/State*

Postal/Zip Code*

Country*

Phone*

Date of Purchase*

Invoice #*

Diamond Identification Number (DIN)*

Polished Diamond Description

Cut/Shape*

Carat Weight*

Colour*

Clarity*

Proportion Information*

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