CERTIFIED COLLECTIBLES GROUP_DEALER MEMBERSHIP APPLICATION & AGREEMENT

DEALER MEMBERSHIP APPLICATION & AGREEMENT

for membership in the dealer network of Certified Collectibles Group - International UK Limited and its Affiliated Companies.
Thank you for your interest in becoming a dealer with Certified Collectibles Group - International UK Limited, the UK-based affiliate of:
- Provenance NGC LLC d/b/a Numismatic Guaranty Company ("NGC")
- Paper Money Guaranty, LLC ("PMG")
- Certified Guaranty Company, LLC ("CGC")
- Signature Authentication LLC d/b/a James Spence Authentication ("JSA")
These companies are all part of the Certified Collectibles Group of companies, global leaders in expert, impartial and tech-enabled services that add value and liquidity to collectibles. For purposes of convenient reference only, they are referred to collectively and individually in this document as "Certified Collectibles Group Companies." Authorized Dealers receive the most exclusive benefits available from Certified Collectibles Group, including grading discounts, full access to an array of digital tools designed to support you and your customers, a listing in the Dealer Locator and much more.

Certified Collectibles Group Authorized Dealers pay just USD $199 per year to access these and other benefits. Authorized Dealer membership renews automatically each year unless it is canceled. Membership fees are due upon notification that your application has been approved. If your application is not approved, you do not have to pay any fees.

An Certified Collectibles Group UK Authorized Dealer may submit collectibles to Certified Collectibles Group in the UK or directly to the Certified Collectibles Group Companies in the United States. Note that not all services (categories of collectibles) are available in all Certified Collectibles Group locations, and submissions will be governed by the services terms and conditions of the specific jurisdiction (Certified Collectibles Group location) to which they are submitted.

To apply for membership as an Authorized Dealer of Certified Collectibles Group UK, please completely read and follow these steps:
1. Fill out all pages of the Application Form & Agreement.
2. Sign to indicate your agreement with and acceptance of the Terms and Conditions.
3. Submit the completed Application Form.
If you have already been approved as an Authorized Dealer Member of any of the US-based Certified Collectibles Group Companies and are applying for Certified Collectibles Group UK Authorized Dealer Membership, you may skip page 4 (References).

All other applicants must complete page 4 (References If you have any questions about this application, please contact Certified Collectibles Group UK at Service@CollectiblesGroup.uk or (+44) (0) 20 3968 3848.

After receipt and review of your application, you will be informed by email whether your application has been accepted. If your application is accepted, you will receive additional information and documentation.
APPLICATION FORM

You are applying for the dealer network of CCG UK.
Your Name
Company Name
Contact Person (if different from name above)
Email
example@example.com
Website
Street address
Street address
Postal Code
City
Country
Phone

Country CodeArea CodePhone Number
VAT ID Number (If Any)
Preferred Language
Are you currently a Certified Collectibles Group UK or Certified Collectibles Group Collector Member?
If yes, Membership #
Are you currently or have you ever been a member of a Certified Collectibles Group Company?
Have you applied for dealer membership before?
You are a member of the following collectibles organizations:
You are an authorized dealer for the following grading services
Your business is:
Please list other partners here:
Date established

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
The current yearly turnover of your collectibles business is:
The majority of your customers are:

Both (Percentage)
What period of collectibles do you sell?
Your primary area of focus within our collectible category is:
(e.g. vintage gold coins, modern Chinese notes, Bronze Age comic books)
Your primary sales channel is:

Other
Collector shows that you regularly attend include:
You use the following to promote your products:

Other
Will you be accepting public submissions to Certified Collectibles Group UK?
How did you learn about Certified Collectibles Group and/or Certified Collectibles Group UK?
Does your business comply with all applicable laws and regulations?
Has your business (or where you are a sole trader, you, or where you are a partnership, you or any of your partners), ever been a subject of bankruptcy, insolvency or related proceedings (including entering into a CVA, IVA or Administration Order)?
(If “Yes,” please explain each instance.)
Are there any unresolved complaints or claims filed with the Courts or any other competent authority (including but not limited to trading standards, the Competition and Market Authority or any other relevant regulatory authority)?
(If “Yes,” please explain each instance.)
To the best of your knowledge, have you or any of the principals, shareholders, directors, officers, members, managers, or employees in your organization or business ever been convicted of or charged with any act or omission that constitutes or involves allegations of dishonesty, fraud, deceit or theft of property?
(If “Yes,” please explain each instance.)
PLEASE LIST FOUR (4) COLLECTIBLES-RELATED REFERENCES WITH WHOM YOU'VE HAD BUSINESS DEALINGS FOR THE PAST YEAR OR MORE. THE SAME REFERENCES MAY APPLY FOR ALL CERTIFIED COLLECTIBLES GROUP COMPANIES.

THIS SECTION MUST BE COMPLETELY FILLED OUT.
Reference #1
Name
Email
example@example.com
Company
Title
Phone
Format: (000) 000-0000.
Address
Postal Code
City
Country
Reference #2
Name
Email
example@example.com
Company
Title
Phone
Format: (000) 000-0000.
Address
Postal Code
City
Country
Reference #3
Name
Email
example@example.com
Company
Title
Phone
Format: (000) 000-0000.
Address
Postal Code
City
Country
Reference #4
Name
Email
example@example.com
Company
Title
Phone
Format: (000) 000-0000.
Address
Postal Code
City
Country
Schedule 1
MODEL CANCELLATION FORM FOR CONSUMER CUSTOMERS (Complete and return this form only if you wish to withdraw from the contract)

To Certified Collectibles Group - International UK Limited, 69 Southampton Row, Second Floor, Bloomsbury, London WC1B 4ET, United Kingdom

TELEPHONE NUMBER: +44 (0) 20 3968 3848

FAX NUMBER: +44 (0) 20 3968 3849

E-MAIL ADDRESS: Service@CollectiblesGroup.uk
[I / We] hereby give notice that [I / We] cancel [my / our] contract for the following Services:
Certified Collectibles Group UK Membership No.:
Certified Collectibles Group UK Submission/Order No.:
Ordered on:
Name of Consumer(s):
Address of Consumer(s):
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature of consumer(s):
Revised: 24 January 2025
© Crown copyright 2013.
CERTIFIED COLLECTIBLES GROUP UK VAT PAYER INFORMATION
Please complete and sign this form to provide CCG UK, the UK affiliate of NGC, PMG, CGC and JSA with your VAT ID Number. You must complete this form even if you do not have a VAT ID number.
Company Name
Account Number (if any)
Street Address
Postal Code
City
Country
VAT ID # (If Any)
Signature
Printed Name
TERMS AND CONDITIONS OF DEALER MEMBERSHIP
SERVICE TERMS AND CONDITIONS OF DEALER MEMBERSHIP
PRIVACY POLICY
PERSONAL DATA AND MARKETING MATERIALS
SHIPPING INFORMATION FORM
Use the below form(s) if you would like your submission(s) to be returned to you directly from the Certified Collectibles Group UK office.

By completing this form, you are authorizing Certified Collectibles Group UK to ship the package(s) associated with the listed submission number(s) directly to the address you provide below.

If you have any questions regarding return shipping or this process, please contact our UK team at Service@Collectiblesgroup.uk.
EXECUTION OF AGREEMENT
I have read and agree to the Certified Collectibles Group UK Terms and Conditions of Dealer Membership, Services Terms and Conditions, Privacy Policy and Credit Card Approval and Release.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
A signature is required to make changes to Customer Authorization information with any Certified Collectibles Group Company.
Should be Empty:

DEALER MEMBERSHIP APPLICATION & AGREEMENT

APPLICATION FORM

Reference #1

Reference #2

Reference #3

Reference #4

Schedule 1

CERTIFIED COLLECTIBLES GROUP UK VAT PAYER INFORMATION

TERMS AND CONDITIONS OF DEALER MEMBERSHIP

SERVICE TERMS AND CONDITIONS OF DEALER MEMBERSHIP

PRIVACY POLICY

PERSONAL DATA AND MARKETING MATERIALS

SHIPPING INFORMATION FORM

EXECUTION OF AGREEMENT