Pre-Long Beach US - page 6

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ABSENTEE BIDDER FORM
BUYER’S FEE
17.5%
PLEASE FILL OUT THIS FORM AND MAIL TO:
11400 W. Olympic Blvd Suite 800
Los Angeles, CA 90064
Attn: Bid Department
FAX TO:
310-551-2626
Bidders who do not have established credit with Ira & Larry Goldberg Coins & Collectibles, Inc. or other leading coin dealers must
enclose a 25% deposit on bids, or bids will not be executed. See our Terms & Conditions for acceptable methods of payment
and before placing any bids. To expedite verification, please provide the full name and zip code of each numismatic reference.
I HAVE ESTABLISHED CREDIT WITH
IRA & LARRY GOLDBERG COINS
& COLLECTIBLES, INC. OR PROVIDED
NUMISMATIC REFERENCES
NUMISMATIC REFERENCES
1.
2.
3.
SIGNATURE
I HAVE ENCLOSED A DEPOSIT IN
THE FORM OF A (CIRCLE ONE):
BIDDER INFORMATION
By signing above, you permit Ira & Larry Goldberg Coins & Collectibles, Inc. to execute your bid(s)
AND agree to the Terms and Conditions of sale.
First Name (please print or type)
Company Name (if applicable)
Street Address (check if new address)
City
State
Zip Code
Telephone Home (Required)
Daytime
Mobile
Last Name
M i dd l e I n i t i a l
Fax
Email
Please send my invoice via:
Fax
Email
Mail
Today’s Date
Resale ID #
Customer #
Money Order
Check
Reference No.
Total Amount $
Name (please print or type)
Business
Daytime Phone
Zip Code
Name (please print or type)
Business
Daytime Phone
Zip Code
:
Name (please print or type)
Business
Daytime Phone
Zip Code
DATE
U.S. Coins & Currency • January 25 - 27, 2015 • Los Angeles, CA
The Pre-Long Beach Auction
1,2,3,4,5 7,8,9,10,11,12,13,14,15,16,...400
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