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Consignment Form
1
Personal Information
2
Coins
3
Confirmation
Thank you for your interest in consigning with Marc Langston Rare Coins! Please fill out the form below. After completing the form, please following the instructions
here
.
Please note that you may also download, fill out, and mail the consignment forms. It is available as a
Microsoft Word document
or
PDF
.
Personal Information
Name
*
First
Last
Company
Make check payable to
*
Name
Company
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Email
*
Coins
*
Date Mint
Denom.
Service Grade
Cert. #
Value (optional)
Notes
Please list each coin below on a row. All fields are required except for the value if it is unknown. Please note: this is for
certified
coins only.
Minimum starting value:
*
MLRC recommended minimum value (recommended)
50% of values listed below
65% of values listed below
80% of values listed below
All coins start at $1 minimum bid
Please select one option to establish and set the minimum bid for your coins.
Total Number of Coins
*
Please enter a number greater than or equal to
1
.
Special Instructions
Signature
*
By signing your name here, you agree to the consignment terms and conditions available
here
(opens in new tab).
Date
*
Month
Day
Year
Name
This field is for validation purposes and should be left unchanged.
Δ
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Certified Coins
Cents
Colonial
Dimes
Dollars
Gold
Half Cents
Half Dimes
Half Dollars
Nickels
Quarters
Bullion
Bars
Rounds
Bidding Information
Ending Soon
Featured Auctions
Uncertified
Cents
Colonial
Dimes
Dollars
Gold
Half Cents
Half Dimes
Half Dollars
Nickels
Quarters
Type
Foreign
Consignment
Instructions and Information
Consignment Form
Consignor Terms
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My Account
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