Fill in this form, then print and mail with payment to:
Mangrove Productions
Art Appraisals
6379 Alderwood St.
Spring Hill, FL 34606
USA

Name
Address
City  State/Province
Postal Code  Country
Phone  Fax
E-mail

Work to be appraised:

Artist
Title of work
Medium
Number (in series)  Size
Source of aquisition
Purchase price  Year purchased
Website (if image is online)
If not online, I am sending a copy of the image by:
fax  e-mail  snail mail

Comments:

Appraisal fee is based on current value of artwork:

Appraisals under $500	$50
Appraisals from $501 to $1000	$75
Appraisals from $1001 to $2000	$100
Appraisals from $2001 to $3000	$150
Appraisals over $3001 to $5000	$200
Appraisals over $5001 to $10000	$250
Appraisals over $10000	$300

Amount enclosed:  

Payment options (select one):
check   money order (U.S.only)   International money order
(Make check or money order payable to DaliLand.)

DaliLand International     http://DaliLand.com