Print Appraisal Request Form
Michael D. Stevenson
LA ARTBOX
10928-3/4 Landale Street
Toluca Lake, CA 91602
| NAME | |
| *First Name |
 |
| *Last Name |
|
| Company |
|
| ADDRESS | |
| *Street Address 1 |
|
| Street Address 2 |
|
| *City |
 |
| *State |  |
| *Zip |  |
| *Country | |
| CONTACT INFORMATION | |
| *Home Telephone |
 |
| Business Telephone |
|
| FAX Number |
|
| | |
| DESCRIPTION | |
| *Brief Description with title. | 
|
| Signatures, Dates, Marks |
|
| Wear or Damage |
|
| Evidence of Restoration |
|
| Size - Height, Width & Depth |
|
| Medium, Materials, Manufacturing Methods |
|
| Provenance or Historical Data |
|
| *Purchase/ Acquisition Date (approximate) | 
|
| *Purchase Price (approximate) |
|
| Additional Unusual Characteristics |
|
| Comments |
|
End of Form
Appraisals
Pedestals & Mounts
