All asterick (*) fields required

*Contact Type:

__________________________________

The information inputted for your Certificate of Authenticity registration is strictly confidential. I input what is sent to me into a spreadsheet, then I delete the email. I will periodically backup the spreadsheet by printing a hardcopy and keeping it with my files. My intentions with this information:
***
To keep an open communication between Creator and Collector -- If I change the site address, contact info, or have news that may affect your purchase, I feel obligated to inform you of such things unless instructed not to. I know it's tough to keep things in-check nowadays, but I hope you can keep me updated as well.
***
Monitoring pieces -- Theft, accidents, lost... crap happens. I would like to note such things when a Collector notifies me of such. It helps to keep on the look-out for frauds, especially if the availability has become more rare or obsolete. Remember, this COA is pretty much a sales receipt. In the event that my work increases in value over time (hey, one can dream), the COA acts as a document that tracks the history of not just one piece, but all my work. If you were wanting to sell it down the road, wouldn't you like to know if it's increased in value?
***
Collector Dibs -- before submitting the form, there is an option if you believe you will become a Collector of my work. This is only an option for previous or current LE/Original purchasers.

__________________________________


*Your Name:
*Email Address:
*Street Address:
*City, State, Zip:
Phone: 12
*Purchase Type:

*Print Title:
*Print Number:
If acquired, BAT Print Number:
If acquired, LOY Code:
Purchase Date:
*Purchase Location:
*Price Paid (USD):

*Do you wish to be contacted via email for "Collector's Dibs" when new pieces are released for purchase before released publicly? This will bestow you a limited time discounted Collector's Cost, due to the fact that I will never put anything "On Sale".

Anything You Wish To Share?

*Title:
If acquired, LOY Code:
Purchase Date:
*Purchase Location:
*Price Paid (USD):

*Do you wish to be contacted via email for "Collector's Dibs" when new pieces are released for purchase before released publicly? This will bestow you a limited time discounted Collector's Cost, due to the fact that I will never put anything "On Sale".

Anything You Wish To Share?

*Comment:
*Comment:
*Your Name:
*Email Address:
*Inquiry Type:

*Piece Title:
*Inquire:


~~~Please be advised that I do not, at this time, do private patron commission work.~~~

*Company/DBA
*Inquire:

*Comment:
*Comment:
Your Name:
*Email Address:
*Tech Type:

*Issue:

*Comment:
*Comment:
*Your Name:
*Email Address:
*Comment:
*Your Name:
*Email Address:
*Comment: