R
oGALLERY
Lat i nAmer i c anSal e Wednes dayMay26t hat1pmEDT
□ ABSEN TEE BID □ PHONE BID
SIGN & FAX TO (+1)718.937.0901
SALE TITLE:
SALE DATE: □ CHECK
I F YOU A RE A FI RST TI ME BI DDER
Name (First/Last)
Telephone # (Main)
Company Name (If Applicable)
Telephone # (Alternate)
Address:
Fax #
City, State, Zip Code
Credit Card Number / Type
Circle One: (AMEX, VISA, MC, DISCOVER) □ USE THIS CREDIT CARD FOR MY PURCHASE E-Mail Address:
Credit Card Ex pirat ion Dat e / Sec urit y #
AUCTION BIDDING INFORMATION LOT #
MAXI MU M DOLLAR AMOU NT O R (X) FOR PHONE BI D
LOT DESCRIPTION (TITLE, ARTIST, MEDIUM)
*EXCLUDI NG BUYERS PREMIUM & TAX
$ $ $ $ I Underst and and Agree t o t he Terms & Condit ions of t he Sale and aut horize RoGallery.com Auct ions t o bid on my behalf up t o t he amount st at ed above,
Signature (Req uired )
X________________________________________________________ (Date) Larger Size d A bsent ee Bi d Form Av ailable onli ne at : rogallery .com/absent ee -bidfor m.ht ml