Consignment Information

Date:   Consignee #

Name    Area Code Phone:

Print 2 Copies, 1 for Madisons, 1 for your records

I declare the above listed goods and chattels are my own property and free from claim. I. the owner have read and agree to the conditions and terms listed here: www.madisonsauction.com/consignment-terms.htm

Accepted By __________________________________  Date_______________________

Consignee _____________________________________  Commission Rate 25 %