Sub Form #: ____________ Date: ____________ Name: __John Doe______________________________ A Address: _1112 Main Street_________________________ CGC 2018 City: ___New York_______State: __NY_ Zip: ___10001___ Submission Phone: ___602-234-2343______ Cell: ___543-980-0433__ EMail: [email protected]________________________ Form Method of Payment: Master Card_Exp:__4/15_ Code: 324_ Ship Items To: Credit Card #/ Trans #: __4432-4563-3457-9903___ Celestial Comics Billing Address: ______________________________________ (if different) Street Address Zip Code 2421 Tech Center Court, Suite 100 Las Vegas, NV 89128 *****Sign form at bottom***** Please refer to website for tier pricing: TIERS: Modern (M) Economy (EC) Standard (ST) Express (EX) Return Shipping Insured No DBase Add’l FastG Comic Title E F TotalH Issue Variant/Pedigree Tier Fee Fee Fees Track Amazing Spider-Man 121 EC FT 1 B 190 10 20 10 230 C _____Stan Lee_______________ ________John Romita Sr__________ Cert /Grade ________________I ______Stan Lee base economy $135 + 55) (he charges $20 plus $10 for one add’t signature) Comic # _____________ Submitted to CBCS ________ Returned to Customer _____ 42 + 2 Amazing Spider-Man 700 Campbell M FT 10 35 10 102 12 _____J. Scott Campbell_______ ___Humberto Ramos___________________ Cert Comic /Grade # ______________ ________________ Cert / Grade ______________ ___________________(he charges $30)___ he charges $5 plus $10 for one add’t signature) Comic # _____________ Submitted to CBCS ______________ Press is $12 for Modern. Add to Base Fee Returned to Customer _____ 3 Uncanny X-Men 141 EC FT 55 10 10 75 __Chris Claremont ___________ ________________________________ Cert Comic /Grade # ______________ ________________ Cert / Grade ______________ ______(He charges $10) ________________ ____________________________________ Comic # _____________ Submitted to CBCS ______________ Returned to Customer _____ 220 + 4 Amazing Spider-Man 129 ST 30 40 295 5 __________Stan Lee__________ _____John Romita Sr___(+$20 fee +$10 add’t) _ CertComic /Grade # ______________ ________________ Cert / Grade ______________ __________Roy Thomas(+$10 fee +$10 add’t) ___Gerry Conway_(+$10 fee +$10 add’t) ____ Comic # _____________ Submitted to CBCS ______________ _(You will need to add $5 to base for the fourth signature - $5 per sig over 3 signatures_)__________J Returned to Customer _____ 5 ________________________________ ________________________________ CertComic /Grade # ______________ ________________ Cert / Grade ______________ _____________________________________ ____________________________________ Comic # _____________ Submitted to CBCS ______________ Returned to Customer _____ 6 ________________________________ ________________________________ Cert Comic /Grade # ______________ ________________ Cert / Grade ______________ Comic # _____________ _____________________________________ ____________________________________ Submitted to CBCS ______ Submitted to CBCS ________ Returned to Customer _____ Returned to Customer _____ EXCLUSION OF WARRANTIES / LIMITATION OF REMEDIES: Although Desert Wind Comics intends to act with the utmost care when handling comic books and related artwork, you acknowledge that, given the nature of our services offered (comic book signings and related services), damage may occur to comics and related artwork, including, but not limited to, tearing, creasing and staining Return Shipping Sub-Total ________K during the handling and signing process. Furthermore, we cannot guarantee CBCS grades will not lower upon resubmission. By using Desert Wind Comic’s services, you agree that you will not hold Desert Wind Comics, its owners or duly appointed representatives UPS responsible for any damage or loss that occurs while your comics are within our possession. Loss by fire, theft and other acts out of ($13 + $2 eacj add’l) Shipping ________ our control are covered by insurance. Any damage or loss that occurs due to our negligence will be remedied by a refund or reduction L of service fees. Insured Fed Ex Desert Wind Comics makes no guarantees as to the time frame in which the items will be signed and returned to the customer. DWC Form Fee $ 5 per form will attempt to get the items signed at the earliest opportunity. DWC has no control over the CBCS grading times. ($25 + $3 x each add’l) By submitting the above listed items to Desert Wind Comics, I have read and accept all of these terms. I authorize DWC to charge my M card in accordance with DWC published rates. I will not dispute or contest the charges on the basis of a card not present (CNP) Registered Mail Total ________ transaction. O Purchaser is responsible for any and all fees, legal or otherwise, if the purchaser files any claims with their credit card company and (starts at $32) N loses said claim. Must Sign*****Signature Form!!__________________________________________ Date______________________ .