Order Form
Some countries will impose custom duties, any
such duties must be paid by the recipient. Please note that this order is
subject to the general terms and conditions on the back of this order form. By
submitting this order you agree to accept them.
Invoice Information |
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Company & contact name
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Address
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Tel |
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Fax |
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E-mail |
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Item # |
Unit price USD |
Qty |
Amount USD
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TOTAL USD (transport excluded)
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Transport to be quoted (free for orders over USD 120) |
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TOTAL USD to be charged:
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Card type
(Visa, Mastercard) |
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Cardholder’s Name |
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Card number |
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Expiration date |
Month |
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Year |
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Signature:
“The above cardholder authorizes PEF to charge for the amount indicated
above as TOTAL USD to be charged”
SEND THIS FORM BY FAX : 00 33 1 49 05 45 80