Proxy Bid

Please print the form below. Fill in the requested information, sign, date and fax the completed form to Stopol Auctions at (440) 498-4001. For questions, please contact us at (440) 498-4000.

Not valid without signature and deposit.

CONTACT INFORMATION

Name (first/last):                                                                                                                                  

Title:                                                                                                                                                   

Company Name:                                                                                                                                  

Address 1:                                                                                                                                           

Address 2:                                                                                                                                           

City:                                                                                                                                                    

State/Providence:                                                                                                                                

Country:                                                                                                                                              

Postal Code:                                                                                                                                       

Telephone:                                                                                                                                          

Fax:                                                                                                                                                     

Email:                                                                                                                                                             

Type of Business:                                                                                                                               

AUCTION/BID INFORMATION

Auction Name:                                                                                                                                    

Auction Date:                                                                                                                                      

Item 1:                                                                                        Bid Amount (USD):                            

Item 2:                                                                                        Bid Amount (USD):                            

Item 3:                                                                                        Bid Amount (USD):                            

Item 4:                                                                                        Bid Amount (USD):                            

Does this include the buyer’s premium?              Yes                  No

Additional Comments:                                                                                                                          

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

Buyer’s Signature:                                                                                              Date: