Thank gawd I haven't had to use an online exchange since Mtgox.
It's faster, easier, cheaper, safer, and fully anonymous dealing face-to-face with an honest neighborhood dealer behind closed doors.
How do you find an honest neighborhood dealer?
You have to develop a good working relationship.
My first OTC buys were from a miner I met through Localbitcoins while Mtgox was in the process of imploding. I guess he paid Localbitcoins that first time but we simply exchanged phone numbers so there were no middlemen after that. I paid him the current buy rate in CAD based on Cavirtex. He was happy to be able to sell enough coins to pay mining expenses without paying fees. He lived in a high-rise condo building a 10 minute streetcar ride from my home. We met and transacted in a glassed-in lobby under the watchful eyes of armed uniformed security. Because I carried only public keys, I wasn't worried about getting mugged on my way home. He was hoping to be retired before age 35. I don't think he had to wait that long. Last time I spoke to him was at the original Decentral the night Vitalik Buterin first announced his plans to develop his sleazecoin. Early January 2014, before Mtgox went down.
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I met my current number one dealer first through Coinatmradar while I was still using ATMs. They had fairly low fees compared to most ATMs at that time, something like 4-5%. I recognized the address as being a local-family owned foreign currency exchange with whom I'd had good experiences, who consistently had the best rates on USD and MXN.
Turns out the owner is a Bitcoin enthusiast who organized meet-ups etc., and we hit it off immediately. I paid 3% that first time and had to wait for a confirmation before getting the cash. After that I was paid as soon as the TX showed on the network. Before long I was paying 2% (or no fee!) and we usually chatted about current market conditions, Bitcoin politics etc.
Once before a trip to Mexico, I inquired about amounts exceeding the government anonymity limits. No problem. Just give a day or two's notice. Eventually I was sending coin to the exchange from the Mexican jungle with my brother in Toronto picking up the cash to deposit to my credit card so I could withdraw cash from an ATM in Mexico. Aaah, the joys of not having a bank account.
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Before that I met OTC dealers when I could. One of the first was a gold dealer I also met through Coinatmradar. The second time I went, their Lamassu ATM had broken down so they sold me some coin OTC. I don't think they ever did actually get the ATM fixed. It was always OTC after that but eventually I found cheaper places. They were also too far to walk to.
I also met several ATM operators because of machine failures who ended up dealing OTC with me. They were quick to cut out the shopkeepers to keep my fees down.
Not all the middlemen were cut out though. One met me in the bar where his ATM was located because he was undercapitalized and didn't have enough cash in the ATM. He met me 2 days later after raising the cash and bought me a couple of Hendricks martinis while we transacted phone-to-phone and cash hand-to-hand all under the watchful eyes of the bar owner who was the ATM owner's friend. When I commented about the large gentleman loitering on the sidewalk out front, they said he was a friend making sure
I didn't try anything funny. On the way out we exchanged smiles. As it is, the bar owner agreed with the ATM dude to a lower fee to woo my business. It was the beginning of a good relationship. I guess she was happy to sell us 4 expensive martinis. He was happy to be a step closer to buying his second ATM.
We never used last names in any of these cases.
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Ultimately it comes down to actually getting out and meeting real people and developing friendships.