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BUYER-BROKER REGISTRATION FORM 5742 West Belmont Avenue Chicago IL October 28 2011 Auction BROKER INFORMATION Agent/Broker Name BIDDER Bidder will be assigned day of auction Address City/State/Zip License Tax Identification Telephone Office Cell Broker/Agent hereby assumes all his duties as Buyer s Broker acting as an agent of the Buyer only and not as a subagent of Schrader Real Estate and Auction Company Inc. Broker/Agent acknowledges receipt of the Broker Participation Guidelines and agrees to abide by the guidelines. BROKER/AGENT SIGNATURE Date CLIENT INFORMATION Phone No Client hereby acknowledges that client will rely entirely on the named Buyer-Broker as his/her agent and is not relying on Schrader Real Estate and Auction Co. Inc* as his/her agent. CLIENT SIGNATURE HOW DID YOU HEAR ABOUT THIS AUCTION Brochure Newspaper Signs Internet Radio TV Friend Other --------------------------------------------------------------------------------------------------------------------------------Fax this form to 260-244-4431 or deliver to Schrader Real Estate and Auction Company Inc* P. O. Box 508 Columbia City Indiana 46725 by Wednesday October 26 2011. THIS FORM MUST BE RECEIVED BY OCTOBER 26 2011 OR IT WILL NOT BE ACCEPTED. BROKER/AGENT SIGNATURE Date CLIENT INFORMATION Phone No Client hereby acknowledges that client will rely entirely on the named Buyer-Broker as his/her agent and is not relying on Schrader Real Estate and Auction Co. Inc* as his/her agent. CLIENT SIGNATURE HOW DID YOU HEAR ABOUT THIS AUCTION Brochure Newspaper Signs Internet Radio TV Friend Other --------------------------------------------------------------------------------------------------------------------------------Fax this form to 260-244-4431 or deliver to Schrader Real Estate and Auction Company Inc* P. Inc* as his/her agent. CLIENT SIGNATURE HOW DID YOU HEAR ABOUT THIS AUCTION Brochure Newspaper Signs Internet Radio TV Friend Other --------------------------------------------------------------------------------------------------------------------------------Fax this form to 260-244-4431 or deliver to Schrader Real Estate and Auction Company Inc* P. O. Box 508 Columbia City Indiana 46725 by Wednesday October 26 2011. THIS FORM MUST BE RECEIVED BY OCTOBER 26 2011 OR IT WILL NOT BE ACCEPTED. BROKER/AGENT SIGNATURE Date CLIENT INFORMATION Phone No Client hereby acknowledges that client will rely entirely on the named Buyer-Broker as his/her agent and is not relying on Schrader Real Estate and Auction Co. Inc* as his/her agent. CLIENT SIGNATURE HOW DID YOU HEAR ABOUT THIS AUCTION Brochure Newspaper Signs Internet Radio TV Friend Other --------------------------------------------------------------------------------------------------------------------------------Fax this form to 260-244-4431 or deliver to Schrader Real Estate and Auction Company Inc* P. O. Box 508 Columbia City Indiana 46725 by Wednesday October 26 2011. THIS FORM MUST BE RECEIVED BY OCTOBER 26 2011 OR IT WILL NOT BE ACCEPTED.

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