Waxahachie Registration Agreement If you are human, leave this field blank.Waxahachie Auction Position RequestContact InformationImportant Information:Please read the complete Terms & Conditions of the sale provided. Keep a copy of this agreement for your records. If you have any questions call Vicari Auction at (504) 264-2277 or email firstname.lastname@example.org. Entry Fee 2. Copy of Front and Back of Title (Name must match this consignment form/Checks to Legal Titled Owner(s) no exceptions). 3. Pictures of vehicle (see photo guide). 4. Copy of Driver\’s License (and Dealer License if applicable).Name: *Dealership:(attach Dealer License copy with registration)Address: *(we will NOT send to a P.O. Box)CountryUnited States (US)United Kingdom (UK)CanadaAustralia—AfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraÇaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqRepublic of IrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaWestern SamoaYemenZambiaZimbabweCityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces (AA)Armed Forces (AE)Armed Forces (AP)American SamoaGuamNorthern Mariana IslandsPuerto RicoUS Minor Outlying IslandsUS Virgin IslandsZip codeLicense #: *Phone (primary): *Phone (secondary):Fax:Email:Vehicle Information:Instructions:High Quality photos are required at time of position request for primetime and feature automobiles to secure those spots, we cannot guarantee these spots without a photo. If reserving a standard entry and not confirming a car at this time, download the Consignment form from the link above and fax to (504) 347-1522. Please submit photos for all known vehicles (please review photo guide attached)Year: *Make: *Model: *Body: *Mileage *Exterior Color: *Int. Color & Fabric (cloth/vinyl/leather) *Engine/Displacement: *Transmission: *Title Branding:Title brandings are listed on the front of the title and may read: Salvage, Rebuilt, Reassembled, Flood, Lemon, etc. If none, write \”none\” or if not certain, write \”not sure.\”Lien Amount:Vehicle Identification Number (VIN): *VIN Location: *Quick Specifications:Power SteeringPower BrakesPower WindowsPower Seat/sPower LocksRemote MirrorsAir ConditioningAdjustable SteeringRemote Trunk ReleaseSwing Away SteeringRemote Hood ReleaseHeated SeatsRear DefrostPower AntennaNavigation SystemCruise ControlStereoKeyless EntrySunroofSoft TopHard TopTinted WindowsChrome TrimContinental KitSpoiler KitHood OrnamentDual Quads4 BarrelAuto Trans.Manual Trans.Fuel InjectionTachometerTri-PowerReserve USD:Including commission, if none write NONE.I have verified my Title matches my vehicles VIN and further understand and agree that vehicles with non-matching Titles/VIN\’s will not be entered into the auction and that no entry fees will be refunded. Furthermore, I have read the auction terms and conditions and agree and understand them in full.Name:Date:Engine Number:Body Number:Age/Quality of Restoration:Vehicle Information/Options:Special Features/Modifications:Provenance or Race History (if any):Awards (if any):Additional Comments:Sellers who wish to declare their vehicles as \”Numbers Matching\” must sign below. If you are not declaring numbers matching, please proceed to next section. I have declared that the vehicle I am selling is a \”Numbers Matching\” vehicle. I attest to the fact that I have personally inspected the numbers on the vehicle and confirm their accuracy. I understand that the generally accepted definition of the term \”numbers matching\” in the collector car market and for this transaction apply to: 1. Engine casting numbers 2. Engine casting dates 3. Engine assembly codes 4. Engine and VIN/serial derivatives All must be present in a manner consistent with the year, make and model of the vehicle. Further, I understand that the Vehicle Identification Number in some instances identifies a specific model or option, and that the VIN of this vehicle is correct for the model and options represented. Any and all remaining numbers on the vehicle may not be applicable to this transaction or meeting the term \”numbers matching.\” I further understand that should the vehicle be sold and found to not have matching numbers, as determined by the buyer and auction company, that the auction company has the right to void the sale, and that I will be responsible for all fees incurred for the sale of the vehicle, to include but not limited to entry fees and all buyer and seller commissions and fees due the auction company. I will further be bound by any and all seller agreements associated with this transaction, and understand that by representing the vehicle as having \”numbers matching\” that I offer a guarantee that may supercede the \”As Is\” terms of the sale.Seller’s NameI have read the Declaration above and wish to declare my vehicle as numbers matching.Auction Schedule/Uploads/Credit InformationDeadlines:Express/Pre-Registration: 4/21/17 On-Site Registration Begins: 5/2/17Seller Commissions:With Reserve: 8% No Reserve: 6% All Memorabilia: 10%FridayNo RerunsSale Opener (Lots 301-305) — $100Standard Entry (Lots 306-319) — $150Prime Time Entry (Lots 320-420) — $200 (minimum reserve $25,000)Standard Entry (Lots 421-450) — $150Feature Entry (Lots 901-910) — $300 (Vicari Auction approval)SaturdayNo RerunsSale Opener Entry (Lots 501-505) — $150Standard Entry (Lots 506-519) — $200Prime Time Entry (Lots 520-620) — $250 (minimum reserve $25,000)Standard Entry (Lots 621-650) — $200Feature Entry (Lots 911-921) — $350 (Vicari Auction approval)Sold OutNone*Feature Cars Run Time will vary and are not in sequential order. *Auction Position(s) will not be confirmed until payment(s) are received. *Seller payments are mailed within 10 Business Days of the auction.Excepted file types (high resolution): jpeg, pdf, eps, tiff. Zip files are also excepted for multiple image uploads, instead of using the individual upload buttons (maximum size of 25mb only), or you may send your images to email@example.com.File UploadFile UploadFile UploadFile UploadFile UploadFile UploadFile UploadFile UploadFile UploadFile UploadFile UploadFile UploadPayment Information:Please provide payment for your lot entry fee. One of our representatives will call you once payment has been processed. Please select card typeMaster CardVisaAmerican ExpressDiscoverOtherCard Number:Expiration Date:00/00 month/yearcvv Code: Name as it appears on card:Billing Zip:SubmitSubmit ClarificationYou must receive a message that your form has been received, if you did not receive the message, you missed a required field, please hit previous button and review your entries.