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I WISH TO BE PRESENT AT THE AUCTION AND I PAY 25€ AT THE FOLLOWING BANK ACCOUNT OF "UNICEF" n° 000-0000055-55 mention: "900089 Smurf auction" |
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I CANNOT BE PRESENT SO I COMPLETE THIS ABSENTEE BID FORM |
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Name of the statue:............................................................................................................................ |
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Top limit of bid in €:............................................................................................................................ |
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I WOULD LIKE TO BID BY PHONE DURING THE AUCTION |
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Name of the statue:............................................................................................................................ |
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CUSTOMER DETAILS |
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Name and first name:......................................................................................................................... |
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Address:............................................................................................................................................. |
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Phone:................................................................................................................................................ |
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Mobile:................................................................................................................................................ |
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Fax:.................................................................................................................................................... |
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Email:................................................................................................................................................. |
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Bank details (IBAN number or Swift number + ID):.............................................................................. |
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DATE: |
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SIGNATURE: |
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Essentials information's |
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WARNING ! TO BE VALID THIS FORM HAS TO BE PRINTED, SIGNED AND SENT BY FAX OR POST TO IMPS: FAX N°+32 2 652 01 60 Rue du Cerf 85 - 1332 Genval Belgium |
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