Application for CCE Services

To allow us to serve you better, please fill in the following information.

NOTE: If your web browser does not support forms, please email Sales@CertifiedCoinExchange.com
with your name, address, and phone number along with any questions or comments.
Be sure to include the words "Application for CCE Services" in the Subject line of the email.

Required fields:  (*)
CCE SUBSCRIPTION SERVICES

The minimum subscription period is three (3) months and your subscription will automatically be renewed month to month unless you give 30 days prior written notice of cancellation.  All charges are in U.S. dollars.  Terms are Credit Card.
CCE shall not be liable for any loss or damage resulting from the use of this service.

Services
CCE - Member Firm   (CCE Exchange Rules)
Includes CCE Quick Price*, CCE bid/ask updating, CCE trade execution, FACTS trading messages, ability to list your inventory on Collectors Corner and more.  Allows one (1) concurrent connection.
$425/month
 
CCE - Associate Member with Quick Price
Includes CCE Quick Price* (viewing only), FACTS trading messages, ability to list your inventory on Collectors Corner and more.  Allows one (1) concurrent connection.
$259/month
 
CCE - Associate Member Firm
Includes CCE Prices (viewing only, does not include CCE Quick Price*), FACTS trading messages, ability to list your inventory on Collectors Corner and more.  Allows one (1) concurrent connection.
$219/month
 
Currency - Associate Member Firm
Includes Paper Money trading messages and posting of currency on Collectors Corner.  Allows one (1) concurrent connection.
$99/month
 
* CCE Quick Price is the one stop coin pricing resource... CCE bids/asks w/dealer IDs, PCGS/NGC population, PCGS/NGC Auction Prices Realized, PCGS Price Guide, Blue & GreySheet (requires subscription), and other resources - all available on one screen!  A must have for quickly and efficiently pricing PCGS and NGC graded coins.
PAYMENT INFORMATION
Payment type:VISA  MasterCard  AMEX  (*)
Name on card:  (*)
Card number:  (*)
Expiration: /   (*)
Security code:  (*)
Comments:
ABOUT YOUR COMPANY
Principal name:  (*)
Title:  (*)
Company name:  (*)
Type of business?Corporation  Limited Partnership  Partnership  Individual  (*)
Your PCGS Authorized
Dealer name and #:
 Please provide at least (1) of the following numbers.
Tax I.D.#:  (*)
Business License#:  (*)
Resale#:  (*)
State Corporation#:  (*)
 
Street address:  (*)
Apt. or Suite:
City:  (*)
State:  (required for USA and Canada)
Zip/Postal code:  (*)
Country:  (*)
Email address:  (*)
Phone number:  (*)
Alt Phone number:
Fax number:
WEB site:
 
Numismatic affiliations: (ANA, PCGS, etc.)
Other affiliations: (Better Business Bureau, etc.)
Briefly list the services, specialties and primary focus of your business:
ABOUT YOUR OWNER(S)

Please answer each of the following questions for each individual owner of the firm.

1. Number of years as full-time coin dealer:  (*)
2. Have you ever been convicted of a felony? If yes, please explain:  (*)
3. Have you ever been convicted of a misdemeanor or felony relating to the purchase or sale of any security, commodity, numismatic coin, or other item relating to the business of a coin dealer, or involving embezzlement, fraudulent conversion, or misappropriation of funds, securities, commodities, or other property, or involving mail fraud, or fraud by wire, radio or television? If yes, please explain:  (*)
4. Have you ever been subject to any administrative order, judgement, or decree of any court relating to your acting as an investment advisor, underwriter, broker, dealer, or commodity broker, or as a person associated with any such party, or from engaging in any conduct or practice in connection with such activities? If yes, please explain:  (*)
5. Are you currently, or have you ever been involved in litigation with another coin dealer, or other litigation relating to your business as a coin dealer? If yes, please explain:  (*)
6. Are you now or have you ever been the subject of an administrative proceeding of any nature instituted by the Securities and Exchange Commission, any state securities or consumer protection official, the Commodity Future Trading Commission, the Federal Trade Commission, any securities or commodities exchange, or self regulatory organization (such as National Association of Securities Dealers or National Futures Assocation)? If yes, please explain:  (*)
CCE COIN DEALER REFERENCES

Please provide at least (3) CCE coin dealer references.
Search for CCE coin dealers. (References are checked.)

CCE Coin Dealer #1: (Please include Company name, CCE ID, Contact, Phone)  (*)
CCE Coin Dealer #2: (Please include Company name, CCE ID, Contact, Phone)  (*)
CCE Coin Dealer #3: (Please include Company name, CCE ID, Contact, Phone)  (*)
CREDIT REFERENCES

Please provide at least (3) credit references.
(References are checked.)

Credit Reference #1: (Please include Company name, Contact, Address, Phone)  (*)
Credit Reference #2: (Please include Company name, Contact, Address, Phone)  (*)
Credit Reference #3: (Please include Company name, Contact, Address, Phone)  (*)
BANK REFERENCES

Please provide at least (1) bank reference.
(References are checked.)

Banking reference: (Please include Bank name, Contact, Phone)  (*)
OTHER INFORMATION
Are you a full-time Numismatist?Yes  No  (*)
Number of years in Numismatics?  (*)
Number of years at current address?  (*)
Please tell how you found CCE/Facts: (eg. search engine, publication ad, dealer referral)  (*)
Any comments or other information would be appreciated:

I authorize Certified Coin Exchange to bill my credit card on a recurring basis.

Thank you for your interest in the Certified Coin Exchange.

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