Tma Direct Cash Form

DIRECT DEBIT / CASH FORM This form must be sent in for all Direct Deposit or Cash payments to be accepted. Sending Options: Please either scan this document and email it to [email protected] (preferred) or alternatively you may fax this to 08 93093044 or post it to PO BOX 1708 Wangara, Perth, Western Australia.

Shipping Details: *First

Name __________________________ *Surname _______________________

Address ____________________________________________________________ *City

________________________*State ___________ *Postcode ______________

*Phone

_________________________ Mobile ______________________________

*Email:

_____________________________________________________________

Special Requirements:_________________________________________________ Product List: (Please tick which products you are interested in purchasing)

$50.00 | David Icke Live in Australia DVD

$85.00 | Thomas Andersons Black Book

$100.00 | Thomas Andersons Classified

$50.00 | Koaʼs Survival Australia DVD set

All prices include shipping throughout Australia, if you are overseas, please include a $10 postage and handling fee to your total. Total payment due: ____________ I am paying Cash (see section A.) | I am paying via Direct Deposit (see section B.) I am paying via Cheque (see section A.)

A) If paying cash or cheque please enclose payment in an envelope with a print out of this form to PO BOX 1708, Perth Western Australia, attention to envelopes and cheques to Adam Davis. B) Direct Deposit can be paid to the following details, please send this form:

Branch: Bank West Hillaries BSB: 306-104 ACC: 0702622 Direct Deposit payment/ref number: _________________________

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Thank You For Your Purchase, Please Refer To The Top Of Sheet For Sending Options TMA Looks Forward To Offering A Wide Range of Products Soon.

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