FAX ORDER

FAX: +34 91 8975000

PLEASE, FILL IN THE FORM IN CAPITALS

PERSONAL DATA 
NAME: NIF:
SURNAME:
ADDRESS:
CITY: CIP CODE:
STATE: COUNTRY:
PHONE: FAX:
E-MAIL (For confirmation):

ORDER
ARTICULE UNITS COLOUR SIZE

PAYMENT (Please tick on the chosen way of payment)
BANK RECEIPT                                            
NATIONAL WIRE TRANSFER (SPAIN) 
INTERNATIONAL WIRE TRANSFER        (5,95 € will be added for the bank steps)

BANK ACCOUNT: 0049 2680 43 2414140392 (IBAN: ES24 0049 2680 4324 1414 0392 ; Swift: BSCHESMMXXX)

POSTAGE (Please tick on the chosen one)
CORREOS Y TELÉGRAFOS  
SEUR (Carriages due)               

Name and Signature