ORDER FORM FOR PROFESSIONAL LEGAL & OTHER SERVICES - Payment by cheque, transfer or Western Union

ORDER FORM FOR PROFESSIONAL LEGAL & OTHER SERVICES
Payments to be made by cheques, transfers & electronic fund transfers like Western Union

The Internaut hereby acknowledges to have read the informations on the service(s) ordered, its/their price and the terms of payment of thesaid price as well as the terms of delivery. He/she also acknowledges to have the legal capacity to conclude this Contract.

This Form entails optional spaces that you are not obliged to fill but also compulsory spaces with this (*).If you do not fill these blank spaces, your message cannot be sent.

First and Last name or Company name		*()**
Name of the person in charge of the order (companies only)		*()**
Address (street or PO Box) :		*()**
City :		*() Country : ()*
Email :		*()**
Fax :		Country code : Number :
Wishes to order the following service(s) in connection with the estimate(s) mentioned hereunder :
N°	*Title of the service(s) concerned ()**	*Code ()**	*Price () (taxes excluded) ()
1
2
3
() VAT to add for orders from Cameroon (19,25%)**
TERMS OF DELIVERY
At the following email (PDF files) :			(*)
I/we also want a paper copy to be sent to me/to us at the following address (by regular post mail or express international mail service at my/our expenses and I/we will be informed of the amount to pay ) :
Expected delivery date (subject to the information on your actual payment) : (*)
*In (city) () date ()* (dd/mm/yy)