PROFESSIONAL SPORTS AUTHENTICATOR CARD …

PROFESSIONALSPORTSAUTHENTICATOR

CARD SUBMISSION # 2499092

P.O. Box 6180, Newport Beach, CA 92658

(800) 325-1121 ? (949) 833-8824 ? PACKAGEINFORMATION: (Customer Must Provide)

Customer Name: 1. Total number of orders included in this package: _____________________________ Customer #: 2. Total number of collectibles included in this package (all orders): ______________

RETURN SHIPPING ADDRESS (print clearly)

_NAME_________________________________________________________ PHONE ( _____ )_________________________ _ADDRESS_______________________________________________________ EMAIL_________________________________ _CITY, STATE, ZIP__________________________________________________ o Check if permanent change of address

PSA USE ONLY

ORDER #_______________________ PKG #__________________________ Date Received___________________ Verified By______________________ Code__________________________

1. TYPE OF SUBMISSION: q Grading q Review q Crossover (one type per submission)

2. T YPE OF SERVICE: (One service level per submission form)

q PREMIUM PLUS . . . . . . . . . . . . . . . . . . . . . . . . . . . $1200 q REGULAR. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $18

Any card with a declared value of $25,000 or higher must be submitted at this service level.

ESTIMATED TURNAROUND: 1 Business Day

q PREMIUM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $800

Any card with a declared value of $10,000 - $24,999 must be submitted at this service level or higher.

ESTIMATED TURNAROUND: 1 Business Day

q WALK-THROUGH. . . . . . . . . . . . . . . . . . . . . . . . . . . . $250

Any card with a declared value under $500 must be submitted at this service level or higher.

ESTIMATED TURNAROUND: 10 Business Days

q CUSTOM ENCAPSULATION (Green Label). . . . . . . . . . . $7

Used for encapsulating custom-made trading cards, such as youth league sports cards or personal photos. Four lines (max of 29 characters per line) are available to customize the description.

ESTIMATED TURNAROUND: Varies by demand q Supersized holder (over 31/2 x 51/8) . . . . . . . . . . . . . . . $10

Any card with a declared value of $5,000 - $9,999 must be submitted at this service level or higher.

ESTIMATED TURNAROUND: 1 Business Day

q SUPER EXPRESS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . $95

Any card with a declared value of $2,000 - $4,999 and all T3s must be submitted at this service level or higher.

ESTIMATED TURNAROUND: 2 Business Days

q EXPRESS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $45

Any card with a declared value of $500-$1,999 must be submitted at this service level or higher.

ESTIMATED TURNAROUND: 5 Business Days

q REHOLDER

q Re-encapsulation of PSA-graded trading card with any declared value for an expedited turnaround.. . . . . . . . . . . . . . . . . . $50 ESTIMATED TURNAROUND: 1 Business Day

q Re-encapsulation of PSA-graded card with a declared value of $5,000 or higher.. . . . . . . . . . . . . . . . . . . . . . . . . . . . $35 ESTIMATED TURNAROUND: Varies by demand

q Re-encapsulation of PSA-graded card with a declared value under $5,000.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $7. ESTIMATED TURNAROUND: Varies by demand

q OTHER_______________________________________________________

Supersized cards, coins and pins are available on each of the above services but must be submitted as a separate order with separate shipping and handling fees. This also applies to crossovers and reviews. Failure to separate will result in additional fees and cause significant delays in processing your order.

Autographed cards dated pre-1998 and/or those not directly from the manufacturer must be sent through Card and Autograph Dual Service (fee may vary depending on card value, see listed restrictions and requirements). Autographed cards dated 1998 and later (direct from manufacturer) can be sent through any of the services listed above (note restrictions and requirements for each level).

3. GRADING FEE CALCULATION _________ x $__________ = $___________

# of items

grading fee

subtotal

4. USPS SHIPPING FEE (per order) -- Select One:

q Domestic Postage, Insurance and Handling (see chart on reverse)

= $___________

q International Postage, Insurance and Handling (see Int'l. chart on reverse) = $___________

Alternate Return Shipping

(Must provide your own FedEx or USPS Express Mail account and insurance coverage)

q FedEx/USPS Express Mail Account #___________________________ Declared Value limit per package (Required):_____________ Purchase FedEx Insurance? o Yes $_______ o No Signature Required? o Yes o No o Sat. Delivery o Pri-Overnight am o Std-Overnight pm o 2-Day o 3-Day o Ground

q Pick Up (by approval only)

5. VOUCHER/CREDIT ON ACCOUNT ? $___________ 6. TOTAL CHARGES = $___________

METHOD OF PAYMENT

q Credit Card Check #_____________ Money Order #_________________________

Cardholder's Name Card Number _____________________________________ Exp. Date Cardholder's Signature

QTY. CATEGORY

SET NAME

YEAR CARD #

CARD NAME

VARIETY (If Any)

CURRENT CERT. #

(Reviews, Reholders and Crossovers)

MIN. GRADE (Required for

Crossover)

NO QUALIFIER

DECLARED VALUE

EX. 1 Baseball

Bowman Chrome

2011 175

Mike Trout

Blue Refractor

$250

1

M

2

M

3 4 5 6 7 8 9 10 11 12

PSA IS NOT RESPONSIBLPESAFOWRILALNNYODTABMEARGEESTPOONCSAIRBDLSESFOUBRMINITCTOEMDPILNETHEARODRPINLAACSCTUICRATOTEPOLRODADERESR.S OR CARD SAVER II.

M M M M M M M M M M

13

M

14

M

15

M

All fees must be paid in advance before PSA can process your order. Failure to include delivery or insurance fees will invalidate turnaround time guarantees. PSA reserves the right to correct submission form to reflect current fees and appropriate shipping and handling fees.

I HAVE READ AND AGREE TO THE PSA TERMS AND CONDITIONS SET FORTH ON THIS FORM. I ACCEPT FULL RESPONSIBILITY FOR COMPLETELY AND ACCURATELY FILLING OUT THE SUBMISSION FORM(S).

TOTAL DECLARED VALUE $_____________ (Required)

AUTHORIZED SIGNATURE (REQUIRED)

Order will not be processed without signature

Turnaround time does not begin until order has been entered

into the grading system. All terms and conditions are subject to

DATE

change. For up-to-date information, visit .

PLEASE SEE REVERSE FOR SUBMISSION INSTRUCTIONS AND TERMS AND CONDITIONS

Form not valid after 12/31/17

U.S.P.S. DOMESTIC POSTAGE, INSURANCE & HANDLING RATE CHART

Number of Items

$1 ? $1,000

PRIORITY MAIL

EXPRESS MAIL

TOTAL DECLARED VALUE

$1,001 ? $5,000

$5,001 ? $15,001 ? $25,001 ? $50,001 ? $75,001 ? $15,000 $25,000 $50,000 $75,000 $100,000

REGISTERED MAIL

$100,001 ? $150,001 ? $150,000 $200,000

1 - 8

$18.00

$29.00

$37.00

$44.00

$56.00

$64.00

$79.00

$120.00 $131.00

9 - 25

$24.00

$35.00

$43.00

$47.00

$63.00

$78.00

$93.00

$130.00 $151.00

26+

add .25 per item

add .25 per item

add .25 per item

add .25 per item

add .50 per item

add .50 per item

add .50 per item

add .50 per item

add .50 per item

Declared Value over $200,000 ? Add $20 for each $50,000 over. Packages over $200,000 will be a two package shipment.

INTERNATIONAL RETURN POSTAGE Insurance Included ? $100,000 Maximum

.CANADA

. ALL OTHER

1 - 10 items $46.00 REGIONS/COUNTRIES

11 - 20 items $50.00 1 - 10 items $55.00

21 - 30 items $54.00 11 - 20 items $60.00

31 - 50 items $59.00 21 - 30 items $65.00 51 - 60 items $69.00 31 - 40 items $70.00

Over 60 - $1.25 per item 41 - 60 items $80.00

EUROPE

Over 60 - $1.25 per item

1 - 10 items $53.00

11 - 20 items $58.00

21 - 30 items $60.00

31 - 40 items $70.00

41 - 60 items $75.00

Over 60 - $1.25 per item

SUBMISSIONINSTRUCTIONS

1. Print your name, customer number, return shipping address, email address and phone number in the space provided.

2. Package Information (Required) -- Be sure to fill out this section completely.

3. Select the Type of Submission. Only one type of submission at one service level is permitted per submission form.

GRADING: For raw cards. You may, but are not required to, specify a minimum acceptable grade. Cards graded below minimum grade will not be holdered; however, the full grading fee will be charged.

REVIEW: For cards previously graded by PSA that you feel might be w orthy of a higher grade. Submit them in holders.

CROSSOVER: For cards previously graded by other companies. PSA will evaluate the card inside the current holder. If PSA deems the card worthy to cross over at the Customer's specified minimum grade or higher, the card will be removed from its holder and placed into a PSA holder. Regardless of the result, the grading fee will be charged.

Please note: Customers using the Crossover Service MUST provide a minimum grade on the submission form. If Customer is willing to accept any PSA opinion, even if the result is evidence of trimming, questionable authenticity, etc., then write "Any" in the column. This may result in the card being returned unholdered. If Customer is willing to accept any PSA grade, then put "1" in the minimum grade column.

4. List the description of each card. For multiple cards of the same type (same year, set, number, and variety), you may list total quantity and write on

one line. On lines listing more than one item, add together the declared value of all items listed on the line and enter total on "Declared Value" column.

5. No Qualifiers (NQ): Cards that have significant flaws will receive "qualified" grades (see definitions online at ). If you select this box and your card is determined to have a qualifier, your card will be graded with a lower straight grade. For example, what would be graded an `8 OC' might be graded a straight `6.' Please note: Some qualifiers may not be removed.

6. Calculate Grading Fee and Shipping Cost (see rate chart). You must remit return postage for EACH order unless you have your own shipping account with Federal Express or USPS Express Service. For international shipments, the customer is liable for any duties and taxes assessed on the shipment to and from PSA.

7. Total Charges and mark Method of Payment. Include check, money order or credit card info. You must include payment or your order will not be processed.

8. Read terms and conditions below. Sign and date the front of the form. Keep a copy for your records. Your order will not be processed unless the submission form is signed.

9. Place each card in a flexible plastic pouch, such as a "Card Saver I." Pouch must be sturdy enough to protect item, but flexible enough to allow us to remove item safely. Do not use hard acrylic holders, screwdowns or top loaders.

10. Package cards and submission form carefully. To help expedite service, turnaround times must be marked clearly on the outside of the package. If submitting multiple orders in the same package, please mark the outside of the

package with the fastest turnaround time. Failure to do so may result in delays.

11. TURNAROUND TIMES: The turnaround times listed on the PSA submission form are estimates and only include Business Days. While our staff works extremely hard to process submissions within the time frame listed, the turnaround times are not guaranteed. During the week of the National Sports Collectors Convention, turnaround times may vary. Check the show schedule for the specific dates.

12. Packages to PSA: United States Postal Service (USPS) and Federal Express (FEDEX) are the only carriers accepted. We do not accept items sent UPS, DHL, or any other shipping company. No exceptions. YOU ARE RESPONSIBLE FOR INSURING ALL PACKAGES TO US.

a.USPS to: PSA, P.O. Box 6180, Newport Beach, CA 92658 b.F EDEX Express Service to: PSA, 7000 Barranca Pkwy., Irvine, CA

92618 (Select "Hold at FedEx location" on air bill). c.F EDEX Ground Service to: PSA, 1921 E. Alton Ave., Santa Ana,

CA 92705

13. Packages from PSA (Return Carrier): a.All orders are returned via Priority, Express or Registered Mail depending on the declared value of the submission. b.F EDEX/USPS Express Mail: If requested, you must have your own shipping a ccount number and insurance coverage. c.Do not send postage stamps, shipping materials or pre-paid postage labels for the return of your package.

14. All terms and conditions are subject to change. For a complete description of all PSA services and to view a list of the items PSA authen ticates and grades, please visit .

PSA TERMS & CONDITIONS

By signing the front side of this form, Customer acknowledges that they have read the PSA Grading Terms and Conditions (the "Agreement") set forth below and agrees to abide by this Agreement, and further agrees that PSA is entitled to rely upon and benefit from this Agreement. 1. PSA will endeavor to grade cards within the time frame, if any, offered as part of a PSA grading service. However, PSA will have no liability what soever to Customer for incidental or consequential damages due to PSA's failure to grade any cards within any time frame. All days are business days. 2. PSA will not grade cards which bear evidence of trimming, recoloring, restoration or any other form of tampering, or are of questionable authen ticity, and Customer agrees not to knowingly sub mit any such cards. Customer agrees that in the event PSA rejects any cards for grading, PSA shall not refund the fee paid by Customer because the determination to reject a card requires a review by PSA's graders and authenticators. Customer represents and warrants that it has no knowledge and no reasonable basis to believe that any card submitted for grading has been altered in any way or is not genuine. For purposes of this Agreement, "altered cards" shall have the meaning set forth in the applicable PSA Autho rized Dealer Agreement or PSA Collectors Club Agreement by and between Customer and PSA (the "Customer Agreement"). If Customer has not entered into the Customer Agreement, Customer hereby agrees to be bound by the terms of the Cus tomer Agreement, a copy of which can be found at join, and Customer's signature on this Agreement shall constitute Customer's signature on the Customer Agreement. Customer reaffirms its obligations with respect to Doctored cards set forth in the Customer Agreement. 3. Grading involves individual judgments that are subjective and require the exercise of professional opinion, which can change from time to time. Therefore, PSA makes no warranty or represen tation and shall have no liability whatsoever to Customer for the grade assigned by PSA to any card, except pursuant to PSA's Financial Guarantee of Grade and Authenticity. 4. An autographed item submitted under the PSA card grading and autograph authentication combi nation service must pass both autograph authenti cation and card grading authentication in order to be encapsulated. For example, a card that is deemed altered in any way will not be encapsulated even though the autograph may be genuine. In addition, if the card is deemed original and unaltered yet the autograph does not pass inspection, then the card may not be encapsulated. There may be very rare ex ceptions to the rule on a case by case basis (in cases where the autograph and card are deemed authentic

?2017 Collectors Universe, Inc.

but the card has been altered in some fashion). In a rare case where an authentic card has been altered, PSA may choose to label the card "Authentic" since the card cannot have a grade assigned. The final determination as to whether a card is encapsulated under these conditions is at PSA's sole discretion. 5. PSA will exercise reasonable care in handling cards submitted for grading, review, or reholder ing. However, if PSA determines that Customer's card was lost or damaged while in PSA's possession, Customer will be compensated based upon the fair market value of the card as determined by PSA stan dard procedures which may include filing a claim with our insurance carrier. The declared value you stated on the front of this form is for estimating the insurance coverage only, and the fair market value of the card may be less than your declared value. IN NO EVENT SHALL THE TOTAL LIABILITY EXCEED THE DECLARED VALUE OF THE CARD. Such compensation shall be Customer's exclusive remedy for any loss or damage. 6. Customer must inspect all cards immedi ately upon receipt and PSA disclaims any liability for damage or discrepancies or errors, including, but not limited to, errors in the description of the card unless reported to PSA within five (5) days of Customer's receipt of the card(s). Customer agrees to return any incorrectly described card to PSA upon request for correction and agrees to indem nify and hold PSA harmless from any and all losses and/or claims caused by the circulation or sale of incorrectly described cards. 7. Customer agrees (a) to pay to PSA all fees and other charges when due; (b) that any delinquent balances shall accrue interest at the rate of 10% per year until paid (or, if less, the maximum interest rate permitted by applicable law); and (c) that PSA shall have a security interest in the cards submit ted, as well as in any other property of Customer in the possession of PSA or its affiliates (collectively, the "Property"), to secure payment thereof. Cus tomer hereby grants to PSA an assignment of and lien against the Property in the amount of any fees and other charges due and payable pursuant to the terms of this Agreement. Customer hereby autho rizes PSA to file, at any time on or after the date such fees and other charges become due, appropri ate uniform commercial code financing statements in such jurisdictions and offices as PSA deems nec essary in connection with the perfection of a secu rity interest in the Property. 8. PSA shall have no liability whatsoever to Cus tomer, or any third party for whom Customer may be acting, (i) for any personal injury or (ii) any damage to any card, or otherwise, resulting from the breaking open of a PSA card holder, or for any damage to any card that PSA can reasonably demonstrate occurred while the card was not in the

custody or control of PSA including, but not limited to, loss or damage to cards while being shipped to PSA, or while being shipped by PSA to Customer by a method selected and paid for by Customer. 9. Except as expressly set forth herein to the contrary, PSA DISCLAIMS ANY AND ALL WARRANTIES, EXPRESSED OR IMPLIED, REGARDING PSA'S GOODS AND SER VICES, INCLUDING, BUT NOT LIMITED TO, THE WARRANTIES OF MERCHANT ABILITY AND FITNESS FOR A PARTICULAR PURPOSE. 10. Notwithstanding anything to the contrary contained herein, except with respect to the rem edies under the PSA Financial Guarantee of Grade and Authenticity set forth at (the "Guarantee"), THE MAXIMUM AGGREGATE LIABILITY THAT PSA SHALL HAVE TO CUSTOMER, OR ANY THIRD PARTY FOR WHOM THE CUSTOMER MAY BE ACTING, ARISING FROM ANY CAUSE, ACT, OMIS SION OR OTHER CIRCUMSTANCE, SHALL IN NO EVENT EXCEED THE GRADING FEE OR LESS ACTUALLY PAID BY CUSTOMER FOR THE GRADING SERVICES RENDERED BY PSA WITH RESPECT TO THE CARDS SUBMITTED FOR GRADING HEREUNDER. IN NO EVENT SHALL PSA OR ANY OF ITS AFFILIATES, OR ANY OF ITS OR THEIR RESPECTIVE EMPLOYEES, OFFICERS, DIRECTORS OR AGENTS, BE LIABLE TO CUSTOMER OR ANY OTHER PARTY FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL OR EXEMPLARY DAM AGES, EVEN IF ADVISED OF THE POSSI BILITY OF SUCH DAMAGES. 11. In the ordinary course of its grading opera tions, PSA (i) compiles data regarding each card submitted for grading, including, but not limited to, data relating to the identity, production, condi tion and grade of the card (the "Data"); and (ii) may take, or have taken, one or more digital or other types of photographs, images or reproductions of each such card (collectively, the "Images"). In con sideration for the grading services being provided by PSA, Customer, on behalf of itself and any third party for whom Customer may be acting, hereby authorizes PSA (i) to compile and maintain such Data with respect to each card submitted here under for grading; and (ii) to take, or cause to be taken, one or more Images of each such card, and further agrees that PSA will be the owner of such Data and all such Images and that PSA may use and exploit such Data and the Images for commercial and any other purposes, as PSA in its sole discre tion deems appropriate, including, but not limited to, the p ublication and republication or reproduc tion in or on any media, of such Data and Images. Without limiting the generality of the foregoing,

PSA Customer Service (800) 325-1121

Customer, on behalf of itself and any third party for whom Customer may be acting with respect to this agreement, unconditionally and irrevocably trans fers, conveys and assigns to PSA any and all current and any hereafter acquired rights, title and interests (including, without limitation, rights in copyright, patent, trade secret and trademark) that Customer or any such third party may have in or to the Data and the Images (on whatever media or in whatever form such Images may be reproduced or published). 12. If any cards are being submitted for a third party, Customer represents and warrants that such third party has agreed and accepted this Agreement and has signed a duplicate copy hereof where indi cated. Customer agrees to provide that third partysigned copy to PSA at any time upon its request. 13. This Agreement is delivered and accepted in the State of California and it is the intention of the p arties that it be governed by and construed in accordance with the substantive laws of that State, without regard to conflicts of laws principles. The parties hereby consent to personal jurisdiction of the courts of the State of California with respect to any legal action to enforce the terms and conditions of this Agreement or otherwise arising under or with respect to this Agreement, and agree that the Superior Court of California, County of Orange, or, if applicable, federal District Court sitting in the County of Orange, State of California, shall be the sole venue, and the State of California shall be the sole forum, for the bringing of such action. Each of Customer and PSA agrees that the prevail ing party shall be entitled to an award of its reason able attorney's fees, costs and expenses. 14. The terms and provisions in this Agreement and the Customer Agreement, if applicable, con stitute the entire agreement of PSA and Customer (and any third party for whom Customer may be acting) regarding, and supersede all prior agree ments and understandings (written or oral) be tween or among such parties relating to, the subject matter hereof. If it is determined that there are any inconsistencies between this Agreement and the Customer Agreement, then this Agreement shall control. If any term or provision of this Agreement is determined, by a final and non-appealable rul ing or order of a court of competent jurisdiction, to be invalid or unenforceable under applicable law, such invalidity or unenforceability shall not affect the validity or enforceability of any of the other of the terms or provisions of this agreement. Each party shall execute and deliver such additional documents and instruments as any other party may request to better evidence or effectuate the agree ments contained herein, including the assignment of rights set forth in Section 11, and procedures, and further agree that PSA is entitled to rely upon and benefit from those terms and procedures.

628506 (card) Rev 11/16

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