Order form :: Jean ELSEN & ses Fils s.a.

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Jean ELSEN & ses Fils s.a.
Avenue de Tervueren 65, B-1040 Bruxelles
Tel. (32-2) 734 63 56 Fax (32-2) 735 77 78 E-mail: lists@elsen.be
TVA BE 0861.750.968

Conditions de Vente · Verkoopsvoorwaarden · Conditions of Sale

List 297

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Warning: The fields with (*) are obligatory - We cannot be held responsible for the non delivery of this order form due to technical internet problems - Buyers must confirm their order(s) by communicating us the signed document by email (scan), fax or letter. We comply to the EU General Data Protection Regulations.

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Observations:
Name:		*I wish to pay by (): International Bank Wire Credit Card Credit Card payments are subject to a 3.5% administrative fee.** MasterCardVisa The information concerning the terms of payment will be communicated with the invoice. A specific authorization form will be requested for a credit card payment as well as a picture/xerox of the card. Deliveries for values less than 1000€ will be made by postal services, deliveries for higher values by private company (a specific delivery form will be requested).
Address:

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Email (*):
References:
By communicating references, you authorize us to proceed to any necessary verification
Shipment (*):	Pick up the coinsMail the coins
I have read the conditions of sale and agree to abide by them. Please buy, on my behalf, the items up to the limits indicated. My participation in the public auction is subjected to authorization from Jean ELSEN & ses Fils s.a. I authorize ELSEN to obtain payment references/information from the mentioned references and I authorize those references to provide payment references/information to Jean ELSEN & ses Fils s.a.

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