BECKETT GRADING SERVICES SUBMISSION FORM

BECKETT GRADING SERVICES SUBMISSION FORM

Send to : Grosnor Distribution lnc.

4 Lowry Drive Brampton, Ontario L7A 1C4

Date: Name:

Account #: Submission #:

Full Name: Address: City: Province: Phone: E-mail:

Customer Information:

Postal code:

Job No.:

BGS Use Only:

Date Received:

Received by:

Veri ed:

#

Sport BB, BK, Qty.

Year

etc.

SET NAME

(please use Beckett Price Guide terminology)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Total Qty.

For additional cards, use another form

CARD #

Auto

CARD/PLAYER NAME

Y/N (please use Beckett Price Guide terminology)

OWNER'S DECLARED

VALUE

CDN Total Insured Value

____ DAYS SERVICE $____ CDN + TAXES PER CARD + INSURANCE

Insurance: Insurance cost applies to all carriers and is based upon the declared value of the package.

Declared Value

$1-$1000 $1001-$2000 $2001-$3000

Fee

$10.00 CDN $15.00 CDN $20.00 CDN

Add $5.00 CDN for each additional $1000 in declared value (or portion thereof).

Calculating $ to be paid to GDI

1. Total # of cards submitted $

2. Grading Fees

$

3. SUBTOTAL

$

4. Auto ($2.00)

$

5. Shipping

$

6. Insurance

$

7. SUBTOTAL #2

$

8. Add Taxes

$

Taxes

5% BC, AB, SK, MB, PQ, PEI, NWT, YK, NU 13% NB, ON, NFL 15% NS

20+ Cards: $1 off per card

40+ Cards: $2 off per card

75+ Cards: $3 off per card

Shipping

$15.00 Flat Rate

Credit Card Info Exp: ___/___ CVC#: ____

White copy - BGS

GRAND TOTAL $

Customer Signature

Yellow copy - BGS Pink copy - Customer Green copy - GDI

GROSOI

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