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| NOTE: This is not an interactive form. Print form, fill it out completely and fax back, or bring it with you to the auction. | |
 P.O. Box 59366, Potomac, MD 20859 (301) 770-3720 Fax (301) 770-4135 E-mail hantman@hantmans.com
BIDDER REGISTRATION INFORMATION
AUCTION DATE:___________________________ BIDDER NO._________________
| | Last Name: | First Name: | Middle Initial: | | Business Name: | | Address: | | City: | State: | Zip: | | Telephone: Home | Work: | | Fax Number: | E-mail: | | MD Tax ID No.: | | Driver's License No.: | State: | Exp. Date: | | Bank Name: | Branch: | | Account No.: | | Telephone: | Contact: | | Credit Card No. (VISA and MasterCard ONLY): | Exp. Date: | I acknowledge that I have read Hantman’s "Conditions of Sale" and understand that they apply to any successful bid(s) that I have submitted.
Signed___________________________________________________________ Date ______________________
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