Richard Basinger Auctioneers Ltd. Referral Form P.O. Box 576, Cortland, OH 44410  (877)638-5816 www.richardbasinger.com Fax To: (330) 638-5806 DATE OF REFERRAL (date faxed)_______________ Your Name:_______________________ Your Phone:______________________ Your Mailing Address:____________________________ Your City:__________________ Your State:_____ Your Zipcode:___________ Company You Are Referring (information) Company Name:_______________________________ Contact Name (if known):_________________________ Company Phone:________________________ Company Address (if known):___________________________ Company City:____________________ Company State:_____ Company Zipcode:______________ If Richard Basinger Auctioneers Ltd. is successful in contracting this auction. We promise to send a check made payable to the above name for 5% of our standard commission rate earned from this auction. There is no limit to the amount of referrals that you give us! Payment to you is made 30 days after the auction has been settled for. In the event that we already have a signed contract on this auction, this offer will be voided.