ORDER FORM

TYPES OF REPURCHASE AGREEMENTS IN FRANCE

(The "Point of Law" is only available in french)

All orders are sent within 24 hours of receiving payment

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Unit price 19 euro TTC   (VAT 5.5%) Postage paid

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For Europe VAT N° SOFICOM : FR 77 352 383 012

Company :
Name :
Job Title :
Address :
Post Code, Town :
Country :
Telephone, fax :
Email :
Quantity :
Payment :	Visa card Cheque
VISA card number
expiry date
cryptogram or CVV2 code
Note :

SOFICOM remains the sole receiver of the informations sent by this order form. In accordance with the loi Informatique et libertés of the 6 january 1978 (Computer and freedom law), you have the right to access, rectify or remove any personal information pertaining to you by contacting us.