Seller’s Name: _________________________________________________________________
Address: _________________________________________________________________
_________________________________________________Phone: _________________________________________________________________
Email: _________________________________________________________________
Number of sale items dropped off today? _____________
Are you placing an ad(s) for large items on the Display Board? ________ Yes ________ No
Name & address where you would like the check mailed? OR Place a check mark on the line if same as above. _______
______________________________________________________==============================================================================
Name ________________________________________________ “Consignor” number _______
# of items in sale _________ Amount collected: _________
# of items sold _________ Items picked up* Y N and/or
#of items not sold _________ Items donated Y N
# of Display board photos _________
Items picked up by: __________________________________________________________________
(Please print name then write your signature.)
Date: __________________________________________________________________