Please enable JavaScript in your browser to complete this form.Sale Date [Sales are held on Saturdays only]PART 1 - CONSIGNMENT FORMVIN: *Year: *Make / Model: *Notes / Owner Statement:Are there any transmission issues with this vehicle: *Yes*No*If YES above, please explain:Are there any mechanical or other issues with this vehicle: *Yes*No*If YES above, please explain:Status: *Previously Sask. registeredPrevious Total LossTotal LossOut of ProvinceSK Safety Inspection completedFlaggedLien Information: *No Money OwingMoney Owing** If money owing, name of financial institution:LayoutReserved [Price]Sell my vehicle with a reserve price*** pickup service available. Vehicle must be in drivable condition*My reserve price will be:UnreservedSell my vehicle unreserved**** includes a free premium detail and in-city pickup. Vehicle must be in drivable conditionUpload your Vehicle Registration OR Bill of Sale: * Click or drag files to this area to upload. You can upload up to 2 files. Please use your most recent vehicle registration.Detail Service:BASIC - exterior wash - $40PREMIUM - wash/vacuum - $80ULTIMATE - wash/vacuum/tire shine/interior detail - $120Delivery of Vehicle: *I will deliver my vehicle to Regina Auto AuctionI need my vehicle picked-up in Regina ($50)I need my vehicle picked-up outside Regina (phone for fee)PART 2 - Terms for AuctionUnder this consignment your vehicle will be placed in a maximum of three consecutive auctions to sell your vehicle. At the request and expense of a potential buyer, your consignment may be subject to an in-house 100-point inspection. LIEN SEARCH: $15; RUN FEE: $15/vehicle/sale; BUYBACK FEE: a) if you choose to remove your vehicle at any point before the end of the third auction sale you are immediately required to pay to Regina Auto Auction the $250 plus GST buyback fee; OR b) if you buy your vehicle back after the third auction, you will be charged a buyback fee of $250 plus GST.PART 3 - Consigner/Seller InformationName *FirstLastMailing Address (including P.O. Box, if applicable) *Address Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPhone *Email *Consigner's Driver's License: * Click or drag files to this area to upload. You can upload up to 2 files. PART 4 - Agreement to SellAuthorization to Sell: *I am the seller, and I agreeBY CHECKING THE BOX IMMEDIATELY ABOVE, I (seller) instruct the auction to sell the vehicle described herein and indemnify and save harmless the auction against all losses and damages sustained at the auction including theft of items or the vehicle itself. Vehicles are left at owner's risk. I hereby state that all the above information is true and that I am the sole owner of the above-mentioned vehicle. I acknowledge the release of all interests, liens and encumbrances in the above vehicle.Date / TimeDateTimeSubmit