Name:

Address: Coinwatch Order Form

Suburb: State: Postcode: Use this order form if you require a specific year date or choice of genuine or commemorative / coin. Please Daytime Telephone No: complete the details required on this form before returning it to [email protected] Email:

Please be aware the additional costs will apply for the Alternative Delivery Address (if different from above) selection of specific year date or coin rarity.

Name:

Address: DROP SHIPPING

Location Courier Cost

Australia POST 9.95 State: Postcode: International FEDEX 35.00

Note: The dispatch date of your order will be subject to stock availability. On dispatch of your order you will receive an email including a tracking number for the shipment.

ITEM CODE YEAR DATE DESCRIPTION QTY $EACH LINE TOTAL (if applicable) EXAMPLE CWA48GAA 1964 Contemporary Collection Mens Gold-Plated Florin Coinwatch 1 $399.00 $399.00

Sub Total $

Shipping Charge $

Grand Total $

PAYMENT DETAILS

I enclose my Cheque / Money Order (payable to “GOLD CORPORATION”) for the amount of $

Charge my (please circle): MasterCard / Visa / American Express

Card Number Expiry Date Security Code

The unique non-embossed number printed on the signature panel on Cardholder Name the reverse of your card or, for Amex holders, it is the unique non- embossed number printed on the front of your card above your main credit card number. HOW TO SUBMIT YOUR ORDER

Email:[email protected] Freecall Australia: 1800 098 817 Returns, Refunds & Exchanges: International: +61 8 9421 7218 Place your order anytime day or night by All items (excluding bullion products) Credit card orders may be placed by emailing the address above. and personali6ed medallion6 carry our phone between 8:30am and 5:00pm 30-Day Money Back Guarantee, which Monday to Friday (AWST). allows the returned items to be replaced Mail: or refunded at the purchase price Delivery: (excluding delivery charges). Please Send your order with your contact our Customer Service Team payment or credit card details to: Orders are normally dispatched within 2 before returning any goods. The days of receipt of payment and subject Reply Paid 6297 stock availability. Delivery usually takes PO Box 6297 1-2 days from dispatch. On dispatch of East Perth WA 6892 your order you will receive an email AUSTRALIA including tracking number for the shipment. Please provide a contact email Fax Australia: 08 9225 5012 to ensure you receive this notification. Fax International: +61 8 9225 5012

TERMS AND CONDITIONS

1. All prices are in Australian dollars and inclusive of GST, where applicable, and 7. 8675$/,$267 is used for all domestic orders. Deliveries must be signed for by are correct at the time of printing. The Perth Mint reserves the right to amend a person at the nominated address. However, if your delivery address is prices without notice. an unmanned delivery box (e.g. PO Box, Parcel Lockers, RMB), our Customer Service Team will dispatch your order via Australian Post as a 2. All items are available at the time of publication and, unless otherwise registered parcel. notified, orders will be accepted on a first-come, first-served basis while stocks 8. Subject to Australian Consumer Law, the proprietor of The Perth Mint, its last. servants/agents make no representations or warranties, express or implied, or offer or give any advice or opinion as to the numismatic or investment value 3. Orders will not be processed without payment. Payments not received within or potential or otherwise of any of the products. seven days will result in cancellation of the order, without notice. 9. Although every care has been taken in the preparation of this publication, The 4. Credit cards will be debited and cheques banked on receipt of order. Perth Mint and its affiliates cannot be held responsible for the accuracy of any statistic, statement or representation made. The Perth Mint and its affiliates 5. If a352'8&7,6over-subscribed or not available, an appropriate refund will be cannot accept any liability for any loss suffered as a result of any action made. whatsoever taken by any person based on this publication. 10. 6. Incorrect payments will be returned for correction before the order can be For full Terms & Conditions refer to: perthmint.com/ermsAndConditions accepted.

PRIVACY AND SECURITY

Gold Corporation (trading as The Perth Mint) does not disclose personal information about any of its customers to any unrelated third party or any unauthorised personnel. Information may only be disclosed to authorised government and legal authorities, and authorised contractors conducting business on our behalf.

RegisteredOffice: For further information on The Perth Mint and its range of precious Gold Corporation Trading as The Perth Mint metal products, please write to us at the address above, email [email protected] or visit our website at ABN: 98 838 298 431 perthmint.com 310 Hay Street East Perth WA 6004