Acknowledgement of User Agreement Form

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Acknowledgement of User Agreement Form

Dear Western Bid:

I declare under Penalty of Perjury that (Please check each box upon completion):

My contact information below is complete, current and valid.

I acknowledge I have read and understood Western Bid's User Agreement and Privacy Policy located at: and , and I ageed to comply with this User Agreement and Privacy Policy.

I am an exempt recipient under the Internal Revenue Service Regulations, I am not a U.S. resident and I am in the age of 18 or older.

Required information (please use English letters):

My Full Name:

My Western Bid Login:

My Email Address:

My Address:

City, Zip Code, Country:

My Phone Number:

IMPORTANT: When sending this page, please be sure to include a proof that your Western Bid registration information is valid in the form of an official governmentissued ID (Passport) You will need to send additional documentation that verifies your address, i.e. a current utility or phone bill.


________________________ ____________________

(Signature - Required) (Date MM/DD/YYYY) 1/1
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