Thanks for all the help!
Still stuck on a couple things:
Coin Date - 2011?
Mint Mark - Casascius?
Owners Value - 1 BTC?
Variety - Casascius 1 BTC?
Thanks again
1. Yes
2. I always leave mint mark blank
3. Owners value can only be up to 100 USD for Physical Cryptocurrency (See bottom left of form where the price is $19 per coin etc).
4. Variety - This is where you put what you want to show on the slab. In your case, I would put CASASCIUS 1 BTC BRASS "CASACIUS IN HOLOGRAM" (XXXXXX) (Where xxxx == firstbits on hologram).
Google for a picture of 2011 error ANACS coin and you'll see what I mean. Sometimes they won't put the first bits down if you don't include them etc etc.
HTH, pm me if you want help on the rest of the form, it's not that hard, it just seems that way the first time you do it.
Cheers.