Request to receive Consignor Payment by ACH

By submitting this secure form, you authorize Cultivate Collectors Services, dba Amelia Jeffers, Auctioneers & Appraisers

to initiate ACH payments directly to your bank account for consignor proceeds.

Your privacy and the security and confidentiality of any information that is sent to us is of the utmost importance.

Please note: information sent by standard e-mail is not secure. Do not send personal information such as your password, account numbers, social security numbers, etc. via standard email.

Name and contact information provided below should match your consignment agreement.

Please describe any disparities between the information provided on this form and the information listed on your consignment contract in the "additional info" field.

First name

Last name

Phone

Street Address

City

State (or Country)

Zip Code

Additional info:

________________________________________________________________

Bank account type:

Checking Account

Savings Account

Your bank's 9-digit routing number:

(usually found on the bottom of a check, beside the account number)

Your bank account number:

Please re-type your bank account number:

I consent to an ACH payment to the bank account referenced above by Amelia Jeffers, Auctioneers & Appraisers in the amount of my consignor proceeds. Amelia Jeffers, Auctioneers & Appraisers will not be responsible for any payments made to the wrong bank account, based on information provided on this form.

Additionally, it is recommended that you send a bank letter or voided check to our secure email address at ameliajeffers@proton.me.

Amelia Jeffers auctioneer appraiser advisor art antiques collectibles

amelia jeffers

Request to receive Consignor Payment by ACH

Name and contact information provided below should match your consignment agreement.