VISA

Order form

Important: First read instructions !
MasterCard
 
Deliver the complete collection 1975-1990 to:
 
Name:
Address:
Zipcode:
City:  
Country:
 
I want to pay with my credit card:
 
Credit card: VISA     MasterCard     (please mark)
Card nummer:
Exp. date:  
Name:
Address:
Zipcode:
City:  
Country:
 
I hereby authorize René van Dijk filatelie to withdraw
once only 327,55 Dutch Guilders from my account.
 
Signature:
Signature
 
You can send this form by mail or by fax.
 
By mail: René van Dijk filatelie
P.o.box 9519
1006 GA Amsterdam
The Netherlands
By fax: + 31 - 23 - 561  9468
 
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