You would like to enter your address in a collectors directory?

If you would like to enter your address in a collectors directory please print this page (File/Print), fill in your address and subjects of interest and send it to us.

lamassu Historische Effekten Internet-Handels GmbH
Forststr. 19b
D-34590 Wabern
Germany




Name          : ______________________________________

Street        : ______________________________________

post/zip code : ______________________________________

City          : ______________________________________

Phone         : ______________________________________

Fax           : ______________________________________

e-mail        : ______________________________________


Collecting interests : _______________________________

                ______________________________________

                ______________________________________

                ______________________________________



I consent to the publication on the internet of the above given
data and their storage by lamassu Historische Effekten 
Internet-Handelsgesellschaft mbH. I understand that there are no 
further costs or obligations for me.




____________________________          _____________________________
City, Date                            Signature