This form is required for all sellers on Trove Market (“Trove,” “our,” “us,” or “we”) to ensure compliance with the Seller Membership Agreement. All information provided will be treated as confidential and used only for the purpose of verifying eligibility to sell on Trove Market. We reserve the right to request additional verification or documentation if necessary.

• Full Name:
• Date of Birth:
• Email Address:
• Phone Number:
• Trove Seller Account Username:
• Street Address:
• City, State, Zip Code:

We are committed to empowering individuals with disabilities through an inclusive, digital marketplace. In order to sell on Trove Market, sellers must have a disability as defined by the Americans with Disabilities Act (“ADA”), which defines a disability as:

• A physical or mental impairment that substantially limits one or more major life activities.
• A record of such an impairment.
• Being regarded as having such an impairment.

In order to meet this eligibility requirement, please answer the following:

1. Please describe the nature of your disability in the space below:
(Note: You are not required to disclose sensitive medical details; however, a brief description is needed to confirm ADA eligibility.)

2. What type of disability do you have? (Please select one or more that apply):

• ☐ Mobility impairment (e.g., use of a wheelchair, crutches, walker)
• ☐ Visual impairment (e.g., blindness or partial vision loss)
• ☐ Hearing impairment (e.g., deafness or hearing loss)
• ☐ Chronic illness (e.g., diabetes, epilepsy, multiple sclerosis)
• ☐ Intellectual or developmental disability (e.g., Down syndrome, autism)
• ☐ Mental health condition (e.g., autism, PTSD)
• ☐ Other (Please specify):

3. Is your disability permanent or temporary?

• ☐ Permanent
• ☐ Temporary   If temporary, please estimate the duration of your condition: months.

In order to sell on Trove Market, sellers must live at or below 250% of the Federal Poverty Guidelines. Please use the chart below to determine if you qualify and check the boxes as appropriate.

For example:
• If you live by yourself, and you make less than about $37,650 a year, you are at or below 250%.
• If you live with one other person, and together you make less than $51,100 per year, then you are at or below 250%.

Using the Chart above, Do You Live at Or Below the Federal Poverty Guidelines?

• ☐ Yes
• ☐ No

By signing below, I certify that the information provided in this form is accurate and truthful to the best of my knowledge. I acknowledge that providing false or misleading information may result in the termination of my seller privileges on Trove Market. I also understand that Trove Market reserves the right to request additional documentation or verification of my disability status if necessary.

Seller Signature:
Seller’s Guardian’s Signature (as applicable):
Date:

Please return this form, along with any required supporting documents, to Trove Market via:
Email: [Trove Support Email]
Mail: Trove Market, [Mailing Address]
For any questions, please contact us at [Trove Support Contact].