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PIANO HISTORY SUBMISSION FORM
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All Fields are Required
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Your name:
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Address:
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City:
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Zip:
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State:
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Email:
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Phone: (xxx) xxx-xxxx
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INSTRUMENT INFORMATION
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Instrument Brand:
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Serial No.:
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Model:
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Finish:
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Please supply us with as much descriptive information as possible (e.g., general condition - both paying and
cosmetic, size (height, length), any additional markings, logos or decal ID's, etc.). You may also supply
photographs (see below). Photos are highly encouraged if requesting valuation.:
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Requested Information:
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Date of Manufacture
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Associated Brands
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Company History
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Value*
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I will be sending:
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photos for evaluation.
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Email photos to:
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Info@NWPianoGallery.com
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* NOTE: Without thorough examination by a qualified technician to determine the integrity and
"playability" of your instrument, an EXACT value cannot be established. What we will supply to
you is our best "guesstimate" of what range your piano is likely to sell for based on the
information supplied and reference to past pianos we have had experience selling. Our
valuation holds no guarantee that you can't sell your instrument for more, nor will it sell for less,
as markets change and, in the piano market, value is oftentimes in the eye (and "ear") of the
beholder.
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FEES
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Piano MANUFACTURE DATE ONLY: $ 4.99
Include COMPANY HISTORY and/or BRANDS: $ 9.99 (Press the associated button)
Include VALUE (please include photos) $19.99
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Prior to pressing the SUBMIT button, please note that fees must be prepaid. You may
either pay by PayPal (requested) using the button below or note that you will be
sending a check. If using PayPal, please make sure the email address associated with
your PayPal account is the same as the email address listed above.
If different, please note it below.
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PayPal specific Email address:
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I will pay by check:
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Mail payments to:
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Piano Liquidators
472 W. 7th Ave.
Suite #3
Eugene, OR 97401
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