Agent Form

Date: 17, 18 May 2011

To: William Inglis & Son Bloodstock Auctioneers
PO Box 1165, Tullamarine VIC 3043
Fax: 03 9333 1690

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 17, 18 May 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 GREAT SOUTHERN WEANLING SALE Sale only.
William Inglis & Son Bloodstock Auctioneers

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