Consultation Request Form Please complete all required information and submit with photos. Contact InformationName *Address *City *State *Zip Telephone *Email *Country About the AppraisalType of Value and Intended Use of Appraisal *Replacement value for insuranceFair market value for charitable donationFair market value for estate tax or planningFair market value for saleFair market value for divorceFair market value for asset divisionFair market value for asset managementOther, please describe About the ObjectType of Object *Artist Title Medium *(e.g. oil or acrylic on canvas, watercolor, pastel, ink on paper, print such as lithograph, etching, screenprint)Date Dimensions *(if a print, include both paper and image size)Country of Origin Edition (look for numbers, e.g. 25/100, or letters, e.g A/P)Signature/Stamps Labels Provenance (where the artwork was acquired, i.e. gallery if purchased; if a gift or inherited, please indicate the year received)Condition *(describe any condition issues, i.e. tears, mold, fading, chips, breaks etc.)Please upload jpgs images of artwork *Optional additional image Optional additional image Optional additional image Optional additional image Optional additional image Optional additional image Other Comments Email VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>:
