Investment Gold Order Form

Full Name
Company Name (in any)
What is your Company number?
Full Postal Address
Home Telephone
Work Telephone
Mobile
Fax
Email Address
DOB
How did you hear about us?
Are you a trade customer?
Yes No
If Yes, what is your VAT number?
Reference: INV1283863206
IP Address: 38.107.191.91
My preferred payment method is:

Cheque

Please send cheque to:
GOLD FACTORY LIMITED,
149 The Broadway,
SOUTHALL,
Middlesex,
UB1 1LP.

Bank Credit

Our Bank Details will be emailed to you on receipt of this order form.
Item Price Quantity Total
Sovereign (8g, 22ct gold)    
Half Sovereign (4g, 22ct gold)  
Krugerrand (33.9g, 22ct gold)    
Maple Leaf (1 oz, 22ct)    
10 Gram Fine Gold Ingot    
20 Gram Fine Gold Ingot    
50 Gram Fine Gold Ingot    
100 Gram Fine Gold Ingot    
1 Kilo Fine Gold Ingot    
Please note, we do not supply gold coins by their dates and gold bars by certain producers. We only supply bullion by the weight and not by the names they have been stamped by. Delivery £10
GRAND TOTAL
*I don’t have a printer
Please post me this order form
Please fax me this order form

I , confirm that I have read the terms & conditions set by Gold Factory Limited on their website regarding INVESTMENT GOLD. I understand that delivery will be after cleared funds have been credited in the account of Gold Factory Limited. I further agree to purchase the above gold bullion at the prices shown above. I agree that by submitting this form, I will be liable to purchase the above ordered Gold Bullion from Gold Factory Limited. I understand, should I wish to cancel the above order, then I will be liable to pay GOLD FACTORY LIMITED, 30% of the GRAND TOTAL as cancellation charges.

I have attached 2 forms of Identification as requested.

Signature:________________________________       Date: September 07, 2010