COIN WATCH ORDER FORM Order by MAIL: Print this form, fill in all necessary details and mail to: The Perth Mint PO BOX 6297 East Perth WA 6892 Order by FAX: Print this form, fill in all necessary details and fax to: +61 8 9225 5012 Order by EMAIL: Fill in all details online (click on the respective grey fields) and save the form to your computer. You can then securely upload the form on the following page: www.perthmint.com.au/catalogue/orderForm.aspx You can also attach this form to an Email and send it to [email protected], however this may not be secure. Campaign: PC04 MEMBERSHIP No (optional) ALTERNATIVE DELIVERY ADDRESS, if required (for this order) NAME ADDRESS POSTCODE POSTCODE CITY CITY COUNTRY COUNTRY TELEPHONE No EMAIL PAYMENT Please debit my: Bankcard MasterCard Visa Diners Amex Card Number Security Code Expiry Date / Name on card COIN WATCHES Price QTY Year Date Please indicate whether you TOTAL AUD$ would like a Genuine or Commemorative Florin/Sixpence* Genuine Commemorative Mens Gold-Plated 'Florin' Coin Watch $299.00 CAFL 32313 - 06J25AAA Text Mens Silver-Plated 'Florin' Coin Watch $299.00 CAFL 32111 - 06J25BAA Mens Two-Tone 'Florin' Coin Watch $299.00 CAFL 32212 - 06J25CAA Ladies Gold-Plated 'Sixpence' Coin Watch $299.00 CASI32313 - 06J26AAA Ladies Silver-Plated 'Sixpence' Coin Watch $299.00 CASI 32111 - 06J26BAA Ladies Two-Tone 'Sixpence' Coin Watch $299.00 CASI 32212 - 06J26CAA Mens Gold-Plated 'Florin' Coin Watch $399.00 CAFL 37313 - 06J27AAA Mens Silver-Plated 'Florin' Coin Watch $399.00 CAFL 37111 - 06J27BAA Mens Two-Tone 'Florin' Coin Watch $399.00 CAFL 37312 - 06J27CAA Ladies Gold-Plated 'Sixpence' Coin Watch $399.00 CASI 37313 - 06J28AAA Ladies Silver-Plated 'Sixpence' Coin Watch $399.00 CASI 37111 - 06J28BAA Ladies Two-Tone 'Sixpence' Coin Watch $399.00 CASI 37312 - 06J28CAA Text Courier Delivery within Australia AUD$13.20 per watch Courier Delivery Internationally AUD$25.00 per watch TOTAL Prices include 10% GST. Customers outside Australia will not be charged GST. *When ordering a genuine Australian florin or sixpence, please check the availability of the year-date in the website table. PRIVACYPRIVACY 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. 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 1300 663 991 (Australia only) or (08) 9421 7218. Our official Privacy Policy is available on request or online at www.perthmint.com.au TERMS AND CONDITIONSCONDITIONS 1.Unless otherwise notified, all orders will be processed on a first-come, first-served basis. 2.Orders will not be accepted without payment. 3.Credit cards will be debited on receipt of order. 4.In the event of any one or more of these units being oversubscribed or not available, an appropriate refund will be made and the balance of the order accepted. 5.Incorrect payments will be returned for correction before order can be accepted. 6.Delivery charges must be included, as indicated on the order form. 7.The Perth Mint reserves the right to amend prices without notice. 8.The number of units issued to any individual in response to an order shall be the sole decision of the Director. 9.Subject to mandatory contrary law, the proprietor of The Perth Mint, its 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 or potential or otherwise of any of the units. 10.Guarantee. If for any reason you are not totally satisfied with your purchase, you may return it for a full refund of the purchase price (excluding delivery charges) within 30 days of delivery. Goods must be complete in original condition and packaging. This guarantee does not apply to bullion coin purchases. Please contact customer service on Freecall 1300 663 991 (Australia only - local call cost) or 618 9421 7218 from overseas before returning any goods. 11.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 statistic, statement or representation made. The Perth Mint and its affiliates cannot accept any liability for any loss suffered as a result of any action whatsoever taken by any person based on this publication..