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2011 Australian Commemorative Florins Silver Proof Subscription Order Form

AUSTRALIAN Customers

Member Number (if known)

Name, Address, Email and Contact Details: THIS ORDER FORM IS FOR THE

______SUBSCRIPTION.

______PRINT AND FAX THE COMPLETED ORDER FORM TO 08 9225 5012 ______OR RETURN BY MAIL TO

______THE PO BOX 6297 ______EAST PERTH WA 6892 ______OR CALL 1300 663 991

______

99C SPECIALSHIPPING OFFER APPLIES TO THE FIRST TWO RELEASES

CODE QTY PAYMENT SCHEDULE LINE TOTAL

FLSUB11  4 x $90*

* Pay $90 plus delivery on release of each coin.

$ Sub Total Special Shipping Charge (First 2 ) $ 1.98

$ Per Delivery Registered Post Express Courier Shipping Charge x 2 (see box on left)

1 $7.50 $15.50 $ Grand Total 2-3 $8.50 $15.50 4-6 $9.50 $17.50 7+ $15.00 $17.50 Four separate shipments, each with delivery charge No Lay-by Options offered for this subscription. NB: If order value is more than $1,000, EXPRESS COURIER must Issue prices for subscriptions may change. be selected. Express Courier Deliveries MUST be to the person Payment for the Full Series cannot be accepted up front. specified on the consignment and photographic ID MUST be Case shipped with First Coin, Certificate shipped with Last provided for the goods to be released. Coin

Release Dates: 1927 Australian Florin (11/10); 1934 Australian Florin (12/10); 1951 Australian Florin (01/11); 1954 Australian Florin (02/11)

PAYMENT DETAILS

 I enclose my / Order (payable to “The Perth Mint”) for the amount of $______

Or

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

Card Number Expiry Date Security Code The small number printed on the signature panel on the reverse of your card or, for Amex holders, it is the small number printed on the front of your card.

Cardholder Name Cardholder Signature

2011 Australian Commemorative Florins Silver Proof Coin Subscription Order Form

International Customers Member Number (if known)

Name, Address, Email and Contact Details: THIS ORDER FORM IS FOR THE ______SUBSCRIPTION.

______PRINT AND FAX THE COMPLETED ORDER FORM TO ______(+61) 8 9225 5012 OR RETURN BY MAIL TO ______THE PERTH MINT PO BOX 6297 ______EAST PERTH WA 6892 - AUSTRALIA ______OR CALL (+61) 8 9421 7218 ______

99C SPECIALSHIPPING OFFER APPLIES TO THE FIRST TWO RELEASES

CODE QTY PAYMENT SCHEDULE LINE TOTAL

FLSUB11  4 x $81.81* * Pay $81.81 plus delivery on release of each coin.

$ Sub Total Deliveries TOTAL Order Value under AU$ 2000 TOTAL Order Value over AU$ 2000 Special Shipping Charge (First 2 Coins) $ 1.98 1 2-3 4-6 1 2-3 4-6 NEW Shipping Charge x 2 (see box on left) $ 19.50 22.50 24.50 40.00 43.00 49.00 ZEALAND US, CAN Grand Total $ 19.50 22.50 26.50 45.00 55.00 65.00 & ASIA. WEST 24.50 32.50 36.50 55.00 65.00 75.00 EUROPE Four separate shipments, each with delivery charge REST OF No Lay-by Options offered for this subscription. 24.50 32.50 36.50 65.00 75.00 85.00 WORLD Issue prices for subscriptions may change. Payment for the Full Series cannot be accepted up front. Case shipped with First Coin, Certificate shipped with Last Coin

Release Dates: 1927 Australian Florin (11/10); 1934 Australian Florin (12/10); 1951 Australian Florin (01/11); 1954 Australian Florin (02/11)

PAYMENT DETAILS

 I enclose my Cheque / Money Order (payable to “The Perth Mint”) for the amount of $______

Or

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

Card Number Expiry Date Security Code The small number printed on the signature panel on the reverse of your card or, for Amex holders, it is the small number printed on the front of your card.

Cardholder Name Cardholder Signature

HOW TO SHOP FROM THE PERTH MINT

 Freecall Australia: 1800 098 817 @ Internet: www.perthmint.com.au  Limited Edition Sell-Outs International: +61 8 9421 7218 Place your order online anytime day Some coins have very limited orders may be placed by or night by visiting our website at worldwide mintages and can sell out phone between 8:30am and 4:00pm www.perthmint.com.au You can very quickly. We recommend that Monday to Friday (AWST). Our also log on and check the status of you place your order promptly to friendly team are here to help you orders placed via our website. avoid disappointment.

with all your orders, requests and enquiries. sts and enquiries.  Your Member Number $ Returns, Refunds & Exchanges  Mail Your Member Number is your All items in this catalogue carry our Complete the Order Form overleaf unique ID with The Perth Mint. 30-Day Money Back Guarantee. and send together with your Having it handy when calling us to If, for any reason, you are not totally payment or credit card details to: place an order or make an enquiry satisfied with your purchase, you helps us to help you faster! Your may return it within 30 days of The Perth Mint Member Number is printed on the purchase for replacement or refund Reply Paid 6297 front of this Order Form above your of the purchase price (excluding PO Box 6297 personal details. delivery charges). This guarantee East Perth WA 6892 does not apply to AUSTRALIA purchases. Please contact our Delivery Customer Service Team between

8:30am and 4:00pm Monday to All orders are normally dispatched  Fax Australia: (08) 9225 5012 Friday (AWST) on Freecall within 14 days. If you wish to check International: +61 8 9225 5012 1800 098 817 (61 8 9421 7218 from on the progress of your order, overseas) before returning any please call us on Freecall 1800 098 Credit card orders can be faxed goods. 817 (Australia) or +61 8 9421 7128 seven days a week. Complete the (International) Order Form overleaf with your catalogue selections and credit card details then simply fax to us. TERMS AND CONDITIONS

1. All prices are in Australian , inclusive of GST where applicable, 9. All products will be delivered via the delivery service specified by the and are correct at the time of printing. The Perth Mint reserves the right customer on the Order Form. to amend prices without notice. 10. The number of units issued to any individual in response to an order 2. All items are available at the time of publication and, unless otherwise shall be the sole decision of The Perth Mint. notified, orders will be accepted on a first-come, first-served basis while 11. Subject to mandatory contrary law, the proprietor of The Perth Mint, its last. servants/agents make no representations or warranties, express or 3. Orders will not be accepted without payment. implied, or offer or give any advice or opinion as to the numismatic or

4. Credit cards will be debited and banked on receipt of order. investment value or potential or otherwise of any of the units.

5. In the event of any one or more coins being over-subscribed or not 12. Although every care has been taken in the preparation of this available, an appropriate refund will be made and the balance of the publication, The Perth Mint and its affiliates cannot be held responsible order accepted. for the accuracy of any statistic, statement or representation made. The Perth Mint and its affiliates cannot accept any liability for any loss 6. Incorrect payments will be returned for correction before order can be suffered as a result of any action whatsoever taken by any person accepted. based on this publication. 7. Delivery charges must be included, as indicated on the Order Form.

8. The year-dates on the coins featured do not necessarily indicate the year of release or the year in which they were minted.

PRIVACY AND SECURITY

GoldCorp Australia (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. Generally you have received this information because you have previously purchased from us or you have requested to receive it. Should you no longer wish to receive such information from The Perth Mint, either by mail or e-mail, please contact our Customer Service Centre on Freecall 1800 098 817 or +61 8 9421 7128.

If you have any queries concerning the privacy or security of your personal information held by The Perth Mint, or if you wish to obtain a copy of this information we invite you to contact us on Freecall 1800 098 817 (Australia only) or +61 8 9421 7218.

Our official Privacy Policy is available on request or online at www.perthmint.com.au

Registered Office: GoldCorp Australia ABN: 49 230 812 547 For further information on The Perth Mint and its range of precious 310 Hay Street metal products, please write to us at the address above, email East Perth WA 6004 [email protected] or visit our website at www.perthmint.com.au