Firearms order form for Hayes and Associates

Secure shopping International delivery	Order Form for Hayes and Associates P.O. Box 188, Carterton. New Zealand. Phone +64 (06) 379 6692. Fax +64 (06) 379 5316. Email haltd@actrix.co.nz

	New Zealand orders Please print this page and Fax or post to Hayes and Associates. To purchase firearms or ammunition you are legally required to fill out this form. To read more go to the Legal notices page. You can purchase all other items directly from the web site.
	International orders If you wish to purchase any firearms then please e-mail haltd@actrix.co.nz to obtain the proper forms to fill out. All other items can be purchased directly from the web site and do not require any forms to fill out.

	Personal Details
	Full name:___________________________		Firearms license number:_________________________
	Postal Address:______________________		Delivery address:_________________

	Phone number:_______________________		Fax number:_____________________
	Signature:___________________________
	Firearms/items requested. Please give item name and any numbers where possible

	Payment details. We accept Visa, MasterCard, American Express and cheques.
	Card:_____________________________	Name on card:_____________________________
	Expiry Date:_______________________		Card number:______________________
	Cheque:___________________________			Amount:__________________________
	Police Officer to complete if purchasing a firearm or ammunition.
	I have inspected the firearms license of:_____________________________________________________________________
	And I am satisfied that they are a fit and proper person and the firearms license held by the purchaser entitles them to buy the items listed above.
	Signed:____________________________			Badge No__________________________
	Date:______________________________			Name:_____________________________
	Station address:_____________________			Station Phone number:_______________

Order Form for Hayes and Associates