Agent Form

Date: 2 December 2011

To: William Inglis & Son Bloodstock Auctioneers
PO Box 477, Newmarket NSW 2031
Fax: 02 9398 7975

I, the undersigned hereby appoint:

(name of agent) .................................................................................................. of

(address) ............................................................................................................

to be my authorised Agent to act for me in all matters relating to the purchase of horses at the auction to be conducted by your Company on 2 December 2011 and to complete all necessary documents and in furtherance of such purchases on my behalf.

I understand and agree to be bound by the Conditions of Sale and I agree to pay for all my purchases by my agent.

This agency is revocable only in writing.

Name of Principal: ................................................................................................

Address: .............................................................................................................

..........................................................................................................................

Phone: Business: ........................................ Mobile: .............................................

Lots: ..................................................................................................................

Signature: ...........................................................................................................

The above agency is accepted for the

2011 SUMMER THOROUGHBRED SALE Sale only.
William Inglis & Son Bloodstock Auctioneers

Per: ................................................... Date:.........................................................