New Clients

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Your Last name

Your email

Address Line 1

Address Line 2

City

State

Postal Code

Country if outside the US

Phone

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Shipping Address if different from above

Do you have transit insurance?
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Any limits on your insurance

Please Provide Three Philatelic Reference, Reference 1

Reference 2

Reference 3

Credit Limit Requested: (Maximum amount you anticipate spending in 1 auction)

Notes (optional)