AGENCY PTY. LTD
A.C.N.: 002 588 490
ABN: 80 002 588 490
 
Date Invoice: TAX Invoice:
Group:
Client:
Attention to:
Address:
Media Coverage:
Right Granted:      (Delete photo after first usage/publication)
Currency:
One-time, non exclusive, reproduction rights to photographs listed below solely for the uses and specifications indicated and limited to the individual edition, etc ... (unless otherwise indicated in writing). Omission of credit line will incur 50 to 100 % mark-up on total fee.
Qty Photo ID Description Price
   



  $  
PAY-
- Payment can be paid by: (please check one of the following options)
VISA CARD MASTER CARD AMERICAN EXPRESS
- You can e-mail your credit card details or for more security you can fax this form with your credit card details. (Fax no: 61-2-9281 7251)
Credit Card Type:                                                                      
Name on Credit Card:                                                                      
Credit Card Number:                                                                      
Expire Date:                                                                      
            Signature:                                             
TOTAL INVOICE         $  
Digital manipulation forbidden