Order

Gerhard P. Hirsch 42349 Wuppertal-Cronenberg Nettenberg 6 Germany Telefax: +49(0)202.47 22 92

Please cross: 1. This is an order 2. This is an inquiry

Please fill in: Herwith I order from company Gerhard P. Hirsch (I have read the terms of trade an I agree):

Quantity:

Type:
Special term:

Price:

Transport company: (1. mail, 2. GLS, 3. UPS, 4. FedEx, 5. Post/DHL Paket, ...)

Special agreement: (1. Insurance, 2. By express, ...)

Desired delivering time:

My adress:

Name:

Street:

Zip code:

Town:

Delivering adress: (only, if different)

Payment:
1. Within 14 days by bank transfer (free of charge in E.U. Euro room)
2. by PayPal (Ebay) (free of charge)
3. by C.O.D. collect on delivery (charge: Euro 3,10 in E.U. Euro room)

Value added tax identification number (only in E.U., outside Germany)

Email or telephone number for questions:

© 2002-2007 Gerhard P. Hirsch, 07. Oct. 2007