Instructions:

1. PRINT and complete this form. Attach additional sheets, if required. We suggest that you make a copy for your records.
2. Enclose your high-resolution photographs of FRONT and BACK of frame.
3. Mail your materials to:
   
   

   Eli Wilner & Company
   1525 York Avenue
   New York, NY 10028

NOTE: All fields indicated in bold are required. Due to overwhelming demand for this service please allow 10 to 12 days for a response.

Name:		_________________________________________________
Address 1:		_________________________________________________
Address 2:		_________________________________________________
City:		_________________________________________________
State:		_________________________________________________
Zip Code:		_________________________________________________
Phone:		_________________________________________________
E-mail Address:		_________________________________________________ _______ Check here if e-mail response is required.
Frame Information
Sight or Opening Size:		_________________________________________________
Width of Molding:		_________________________________________________
Photographs of Front and Back of Frame		_________________________________________________
Any Labels, Inscriptions or Signatures on the Back of Frame		_________________________________________________
Any Provenance and Documentation Relating to the Frame:		_________________________________________________