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FedEx) 3 Company/Individual Name: Address: State: City: Signature of Account Owner 05.01.2015 Zip: Email: Phone: 4 Buyer's FedEx Account#: IAA FedEx ($12 must be paid first before title can be shipped via FedEx) Buyer Number Date Please submit the completed and signed form to your local IAA Branch or email or fax to Buyer Services. Insurance Auto Auctions ATTN: Buyer Services 701 Harger Road, Suite 201 Oak Brook, IL 60523 E-mail: cservice iaai.com.

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