Application for Certificate

 

PHILATELIC FEDERATION OF SOUTH AFRICA

EXPERT COMMITTEE

PO BOX 304

MONTAGU

6720

 

 

Date:

 

I request that the accompanying item be submitted to the Expert Committee for examination:

 

COUNTRY:

 

DESCRIPTION:

 

 

CATALOGUE USED & NUMBER:

 

INFORMATION DESIRED:

 

I agree to be bound by the conditions, as published, governing the acceptance by the Expert Committee of the above item.

 

NAME:

 

ADDRESS:

 

 

 

EMAIL:

FAX:

CELL:

PFSA HOME SOCIETY (if applicable):

 

I WOULD LIKE MY ITEM RETURNED TO ME BY:

REGISTERED MAIL…………………………………………..

REGISTERED MAIL PLUS INSURANCE:…………………..

SPEED SERVICES OVERNIGHT COURIER:……………...

 

SIGNATURE: ……………………………………..

 

Please note: a separate application form must be submitted, please, for each item.