Please complete this form for all orders that meet the following:
1. The order was sent to a U.S. address
2. The tracking information for the order states Delivered but has not been received
3. You have contacted FedEx or the Post Office and asked them to investigate your lost order
4. The investigation with FedEx or the Post Office was closed without your order being found

First Name Last Name

Phone E-mail

I am a ...

Account Number Order Number

Address 1 (Line 1)

Address 2 (Line 2)


State Zip Code

Please note that before submitting this form, we require you to first contact FedEx or your local Post Office and attempt to locate your order. If you have not yet done so, please contact FedEx or your local Post Office and ask them to investigate your lost order. For all FedEx SmartPost orders, the investigation must be started by contacting your local Post Office. To contact FedEx, please go to and click on the ‘File a Claim on a Package’ link on the lower left-hand side, or call 800-GoFedEx. To find your local Post Office, please go to and click on the ‘Find Locations’ link on the left-hand side, or call 800-ASK-USPS.

I have contacted FedEx or my local Post Office

Yes No

Briefly tell us the results
of the Post Office investigation

Please provide any questions
or additional comments

Providing your three-digit initials in the space below will serve as your electronic signature. By providing your electronic signature, you are verifying that the information provided on this form is true and accurate to the best of your knowledge. Providing your electronic signature also confirms that you acknowledge that completing this form does not guarantee any compensation for your lost order and that if It Works deems compensation is needed: it will be in the form of a replacement order.

Electronic Signature