New, Paper Mate Midnight Blue PhD Ball Point Pen and .7mm pencil with original upc code sticker (NOTE- I remove the sticker when I clean the unit so if you want it attached let me know). Easy Grip, flawless writing, and extremely durable. Very hard to find. Voted by Physical Therapy Association as an implement that is ergonomic for the hand and a recommended buy. Pencil is an added bonus making the set match perfect. Great if you are elderly with arthritis or if you are a child learning to write. It is well balanced with the triangular grip that is unmatched. Extremely comfortable and durable deserving of its status. Extremely rare in new, unused condition.