Commercial, Municipal and Industrial Auctioneers, Since 1983

Print this page and complete all fields

Sale Date: ______________________

Sale Location: ___________________

Bus Number: ____________________ (as per auction flyer)

Bid amount: $_______________

 

First Name: _________________________

Middle Initial: ______

Last Name: _________________________

Address: _______________________________________________

City: ______________

State:______________

Zip Code: __________

 

Is this for a company? YES    or     NO

Company Name Buying for: ________________________________

Phone: _________________________________________________

Mobile Phone: ___________________________________________

Fax Number: ____________________________________________

Would you like to be added to our fax list?  YES    or    NO

Bank Name: _____________________________________________

Bank Account Number: ____________________________________

Bank Phone: _____________________________________________

Bank Contact: ____________________________________________

 

Authorized Signature________________________________________   Date: ___________

If different from above

 

Your Name________________________________________________  Date: ___________

 

Any questions at all regarding this form, please contact Bruce, at 810-687-3812.

Use this area if you are interested in more than one item: