Consignment form

Artist* :

E-mail* :

PaintingSculpturePhotographyOther :

Image :

Title* :

Size* :

Medium* :

Support* :

Year of creation* :

Artist inv. No. :

Photo JPEG No.

Stretcher : standard (3/4 inch)profil (1,5 inch)other

Frame: yesno

Molding type :

Frame cost :

To be paid to the artist :

Provincial Tax No. (Q.S.T) :

Federal Tax No. (G.S.T) :

Other tax No. () :

Comments :

You will receive a confirmation in a few days by email when the document will be processed by a person of Galerie MX.