CURRENT DATE___________________________________CAR SALE NO._______________
SELLER'S NAME___________________________________________________________________
SELLER'S
ADDRESS________________________________________________________________
CITY______________________________________STATE______ZIP_________________
PHONE#______________________________DEALER LIC#__________________________
YEAR_________MAKE___________________MODEL/BODY TYPE_____________________
COLOR______________________SERIAL NUMBER________________________________
HISTORY & DETAILS_________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
AMOUNT OF LIEN__________________NAME OF LIEN HOLDER_______________________
ADDRESS_______________________________________STATE______ZIP____________
RESERVE AMOUNT GROSS SELLING PRICE INCLUDING COMMISSION____________________
COMMISSION RATE 5%
OWNER'S SIGNATURE______________________________________________________________
TO CONSIGN A CAR:
SEND PHOTO IF YOU WOULD LIKE PHOTO ON WEB SITE
COPY & SEND COMPLETED FORM , AND PAYMENT TO:
ANTIQUE CLASSIC CAR AUCTION, 5842 BILLY JOR CIRCLE, BESSEMER, AL 35022
