SHELF COMPANIES NSW{VIC.QLD} PTY LTD. www.shelfcoys.com.au

Ph 0266 55 6659 Fax 0266 555 606

Em john@shelfcoys.com.au ABN78 106 239 758
PAYMENT DETAILS. Please complete;

Note. A Submit Button is included; the form legally requires a signature; so please just print your name in the signature box and 'Submit,' This is a" Digital Signature"and is Permissable.[*are required fields]

Ordered By; *
Address; *
Postcode
Phone and Fax Numbers; *
E.mail Address;
'Signature'/Date

Post Documents To;

To Above! Other?
Address;

Overseas Banking Prefix; WPACAUS2S

Payment may be made by the following

Bpay
Bank

 

Biller Code;

150904

Your ref Invoice Number will be;
21477
Direct Deposit to Westpac; Shelf Companies NSW Pty Ltd
BSB 032 585 Account 12 1882
Park Beach Plaza Coffs Harbour
Your Banks Transaction Receipt Number

Please obtain the Bank Payment Transaction Receipt Number and insert above or Fax or E~Mail to us

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Any Queries you should RING me 0266 55 6659