Name _________________________________________Email: ________________________________________________
Home Phone: _______________________________Alternate Phone:________________________Fax#_________________________
Address________________________________________________City ___________________________State Zip________
TAX EXEMPT BUYERS MUST PRESENT A COPY OF RESALECERTIFICATE – PLEASE CONTACT GALLERY FOR FORM.
Signature: ____________________________________________________________________DATE __________________________
Bids will notbe executed without signature. Signaturedenotes that you agree to our terms.
**IN ORDER TO HOLD YOUR BIDS, A CREDIT CARD (VISA,M/C, OR DISCOVER) IS REQUIRED**
Any uncollectedpayments will automatically charge to this credit card 5 business days afterpurchase
Credit Card#_________________________________________________________ ExpirationDate____________ Security Code_______
Cardholder's Signature: _________________________________ BillingAddress:________________________________________________
LIVE AUCTIONEERS BIDSare subject to a 21% BUYER’S PREMIUM!
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