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OFFICE USE ONLY OFFICE USE ONLY

PC04 CoinWatch Order Form

Member Number: or NEW Member?  Delivery Address  Change of Address (Member Number as printed on the Order Form sent with this catalogue, if applicable) (if different from completed on left)

Mr/Mrs/Miss/Ms: ______Mr/Mrs/Miss/Ms: ______

Address: ______Address: ______

______

Suburb: ______State: ______Postcode: ______Suburb: ______State: _____ Postcode: ______

Daytime Telephone No: ______Daytime Telephone No: ______

E-mail: ______E-mail:______

COINWATCH ITEM CODE DESCRIPTION QTY $ EACH LINE TOTAL

CAFL 38116 Generation-X

Sub Total $

Shipping Charge (see box) $

Grand Total $

Delivery Options Express Courier Australia $15.50 per order International $25.00 per order

PAYMENT DETAILS

 I enclose my / Order (payable to “The ”) in 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:

Our friendly Customer Service Team is available on 1300 663 991 (Australia) or + 61 8 9421 7218 (International)

HOW TO SUBMIT YOUR ORDERFORM

 Mail  Your Member Number $ Returns, Refunds & Exchanges

Complete the Order Form overleaf All items carry our 30-Day Money Your Member Number is your and send together with your unique ID with The Perth Mint. Back Guarantee. If, for any payment or details to: Having it handy when calling us to reason, you are not totally satisfied with your purchase, you may return The Perth Mint place an order or make an enquiry helps us to help you faster! it within 30 days of purchase for Reply Paid 6297 replacement or refund of the PO Box 6297 purchase price (excluding delivery East Perth WA 6892 charges). Please contact our  Delivery Customer Service Team (between 8:30am and 4pm Monday-Friday WST) All orders are normally dispatched within 14 days. If you wish to check on 1300 663 991 (61 8 9421 7218 Fax: (08) 9225 5012  on your order’s progress, please from overseas) before returning any

call us on 1300 663 991. goods. Credit card orders can be faxed seven days a week. Complete the 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, and are 9. All products will be delivered via the delivery service specified by the customer on correct at the time of printing. The Perth Mint reserves the right to amend prices the order form. without notice. 10. The number of units issued to any individual in response to an order shall be the 2. All items are available at the time of publication and, unless otherwise notified, sole decision of the Director. orders will be accepted on a first-come, first-served basis while last. 11. Subject to mandatory contrary law, the proprietor of The Perth Mint, its 3. Orders will not be accepted without payment. servants/agents make no representations or warranties, express or implied, or 4. Credit cards will be debited and banked on receipt of order. offer or give any advice or opinion as to the numismatic or investment value or potential or otherwise of any of the units. 5. In the event of any one or more being over-subscribed or not available, an appropriate refund will be made and the balance of the order accepted. 12. Although every care has been taken in the preparation of this publication, The Perth Mint and its affiliates cannot be held responsible for the accuracy of any 6. Incorrect payments will be returned for correction before order can be accepted. statistic, statement or representation made. The Perth Mint and its affiliates 7. Delivery charges must be included, as indicated on the order form. cannot accept any liability for any loss suffered as a result of any action whatsoever taken by any person based on this publication. 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 1800 098 817.

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 (08) 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