(* - required)
*First Name
 *Last Name
Company
 Title
*Phone (work)
 Ext 		 Phone (cell)
ex: xxx-xxx-xxxx
Phone (home)
 Fax
*Email
 *Confirm Email
Website
http:// 
*Address
  		*City
 
Address (cont.)
*State *Zip
   
Shipping Address:    Check here if same as mailing address
Shipping Address
 City
Address (cont.)
State Zip
How Did You Hear About Us?
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       equipment that Media Concepts is seeking to purchase.
Listing your equipment is a free service offered by Media Concepts, Inc. We reserve the right to choose which equipment is added to our database.
*Equipment Type
 
*Make *Model
   
*Equipment Location Currently In Use? Date Available
  Yes  No (mm/dd/yyyy)
Reason For Sale Year Manufactured Serial Number(s)
 
*Cosmetic Condition
 
*Operating Condition
 
Hours Used (if applicable)
1. On some machines, it may be necessary to multiply the hour readings by 10. If this applies,
    multiply all your hours by 10 and put these numbers in the boxes below.
2. If in doubt, the actual hours can usually be viewed on a monitor through the machine's output.
Hours of Operation Drum Hours Tape Run Hours Thread Cycle
Were these hours read from:
Machine's External Display  A Monitor  Don't Know
Does this machine have:
Original Heads?  Replaced Heads?  Don't Know
Operating Manual:
Yes  No   		Service/Technical Manual:
Yes  No  
*What warranty will you offer at time of sale?
Explain "Other" or clarify terms of warranty
*Asking Price:
$ The asking price is what you want to net for your equipment. The price we will publish is a mark-up above your asking price.
Quantity
 
Comments, Description, Options, Accessories
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Do you have more equipment to list for sale?*