REQUEST FORM

To: taufikrezza@yahoo.com
Order From:

Name:

Address: H/P No:

Postcode:

E-mail:

Instructions to fill this form:

1. For make you became easy to order, just put the PRODUCT ID for item that you
want to order which items have listed on the provided catalog.

2. For items not listed in catalog, you just give me the specification of that items
you want at ITEMS column.

N PRODUCT ITEMS VALUE QUANTITIES

O. ID.

Please do not hesitate to contact us should you require any further clarification or information. We assure you of our
very best service to you at all times.