BOUTIQUE d'ARTCOVER

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Buying orders
SALE DATE : / / SALE TITLE :

Last name :
First name :
Adress :
Zip code :
City :
Personal phone number :
Office phone number :

By using this form, I signify my assent to the terms of sale described in the catalogue and request you to acquire for my personal account, in respect on my financial conditions (excluding buyer's premium and taxes), the items that I indicated below.

Lot number Lot description Off limit in euros
t N°

If you do not incline a bank account number to fax, please fill the form below.

Bank :
Responsible for your bank account :
Adress bank :
Phone number bank :

Bank code

Counter code

Account numbere
Key

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