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Get Payment Authorization Website Access Information

A membership with the American Numismatic Association is required when filling out this form. For an account with the ANA please call 800-367-9723 or visit www.money.org Please print clearly. When completed, please sign and send the completed application to: Select your collecting interest: (choose one): q Coins q Paper Money Name: ANA Membership #: Address: City: CCG PO Box 4711 Sarasota, FL 34230 Fax: 941-360-2553 Phone: ( ) Fax: ( State: Zip: ) Birthdate: / / Website Ac.

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