Refining Information Form      
* Required Fields

*Name *Company
Address City
State Zip

*eMail
*Phone Fax:
Business Type Website
   
 *Shipping Company:                                 

Material Being Shipped   * Record Wt & Unit of Measure (dwt, oz, pds) in each field for material shipped.
 
10K PD    
14K PT    
18K                 * Stone Removal: Check only if you want stones returned.

Floor Sweeps   Polishings                        Silver       

Dental Filters Watch Bands
Mixed Kt Carpet Batteries
Grinds Goldfill Vacs
Flash Optical Other
Bench Filings Industrial Other

Market & Settlement Option
 
Day of Rec: 3 Day Avg: Called / Approved Hedge: $
Will Call:               
  *Note: Dental (1A) 10th Mkt. day; Dental (2A) 15th Mkt. Day; All PT 20th Mkt. Day
Settlement (Check all that apply)
 
Call: Casting Grain: Solder:
Credit: Coins: Bullion:
Check: Make check payable to:  
Consignment:                 Special Settlement Instructions:

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 - Before Submitting the completed Form use your browser print button to print two copies of the Form:
   One copy to send along with your Job and a second copy to keep for your records.
 
 
                                                                                 
 

   Shipping Options:

           
U.S Registered/Insured:          UPS or Truck:                        www.stebgo.com
        Stebgo Metals, Inc.                  S.M.I.                                800-289-0138
        P.O. Box 7                              250 Bridgepoint Drive          651-451-8888
        So. St. Paul, MN 55075
                    So. St. Paul, MN 55075        651-451-1397 Fax