Please print the order form, fill it and fax it to Fax- (0049- 511) 34 51 15
	Name Street Postal Code Place Telephone Fax Email
					Antik & Art GmbH 30175 Hannover Königstraße 47 Telefax (0511) 34 51 15
	I recognise the terms and conditions of Antik & Art  and I order hereby the following articles:  No. of article Title number of pieces price total amount Total amount:
	I would like to pay: Via bank transfer Via Cheque Via Credit card		If you pay by credit-card please fill in: VISA Mastercard Maestrocard Card No.: Expiry Date:
	Place/Date: Signature: