Wilson Auctioneers Inc. 929 Airport Road, Hot Springs, Arkansas 71913 1-877-BID2BUY 501-624-1825 Fax 501-624-3473 firstname.lastname@example.org BUYER BROKER REGISTRATION FORM Don't forget - this form must be signed and mailed, emailed, or faxed to Wilson Auctioneers, Inc. at least 48 hours prior to the auction. All information fields must be completed or your registration may be rejected. AUCTION PROPERTY INFORMATION: Auction Date: ________________________________________ Reference #: _________________________ (see ID=# in web address line at auction calendar) Auction Address / Location: ______________________________________________________ Auction City: __________________________________ State: __________________________ BROKER INFORMATION: Principal Broker Name: ______________________________ Federal ID #: ________________ Agent Name: _________________________________________________________________ Company Name: ______________________________________________________________ Address: _____________________________________________________________________ City: ___________________________________ State: ______________ Zip: ______________ Phone: _______________________________ Fax: ___________________________________ Email: _______________________________________________________________________ BUYER INFORMATION: Name: _______________________________________________________________________ Address: _____________________________________________________________________ City: ___________________________________ State: ______________ Zip: ______________ I, _________________________________, Real Estate Broker/Agent, with_______________________________, Real Estate Agency, agree to represent ________________________________________________, as my Client. I agree to be present at the Auction with my Client & will represent them at that time. I acknowledge this form must be returned to Wilson Auctioneers, Inc. at least 48 hours prior to the Auction, signed and dated by both my Client and myself. Wilson Auctioneers, Inc. will accept only one Client per Auction from any one Real Estate Agency. ____________________________________________________________________________________________ Real Estate Broker/Agent Date ____________________________________________________________________________________________ Client Date Notice: No broker will be recognized for a prospect who has previously contacted Seller or Wilson Auctioneers, Inc. or has been previously contacted by Seller or Wilson Auctioneers, Inc. Wilson Auctioneers, Inc. reserves the right to reject any client who is presently on our customer / client mail list.