BECKETT GRADING SERVICES SUBMISSION FORM

Job No.:

Date Received:

Received by:Postal code:

Full Name:

Address:

City:

Province:

Phone:

E-mail:

Customer Information: BGS Use Only:

Veri�ed:

#Sport

BB, BK,etc.

Qty. Year SET NAME(please use Beckett Price Guide terminology)

CARD/PLAYER NAME(please use Beckett Price Guide terminology)

AutoY/N

CARD#

OWNER’SDECLARED

VALUE

1

2

3456

789

10111213

14

Total Qty. For additional cards, use another form 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 Fee

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

$15.00 CDN$20.00 CDN

$10.00 CDN

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

2. Grading Fees40+ Cards:$2 off per card

20+ Cards:$1 off per card

75+ Cards:$3 off per card

White copy - BGS Yellow copy - BGS Pink copy - CustomerGROSOI

8. Add Taxes

6. Insurance

$

Taxes5% BC, AB, SK, MB, PQ, PEI, NWT, YK, NU 13% NB, ON, NFL15% NS

5. Shipping

4. Auto ($2.00)

Date:

Name:

Account #:

Send to : Grosnor Distribution lnc.

4 Lowry DriveBrampton, OntarioL7A 1C4

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

1516

Green copy - GDI

Submission #:

Shipping$15.00 Flat Rate

Customer Signature

Calculating $ to be paid to GDI

1. Total # of cards submitted

3. SUBTOTAL

7. SUBTOTAL #2

GRAND TOTAL

$

$

$

$

$

$

$

$