Form # _____

CONSIGNMENT FORM

Consignor Name:
Address:
Contact Number:

Quantity Title/Description Medium Size Year Artist Price

I __________________ (consignor), hereby certify that all items listed and supplied to (referred
to as auctioneer), are free and clear of all encumbrances and/or liens. I have full legal right to
sell any and all items supplied to auctioneer. I will hold the auctioneer not accountable for any
legal actions that may arise from the sale of any and all goods. Auctioneer has the right to
catalog any and all items as they see fit. I certify that all items are in working condition and free
of any defects unless otherwise noted on consignment form. I understand that all items will be
sold at online auction to the highest bidder on the date of ____. I understand that all items sold
at auction may/will be subject to a buyer's fee which is decided by and goes to the auctioneer.

Commission Rates: The consignor agrees to donate all amount to The Noche Buena Project.
Unsold Properties:

The seller/consignor hereby signs & agrees to all the terms specified in this addendum to
consignment/auction agreement and the original contract.

Seller/Consignor Signature Date

Auctioneer Signature Date