Order - Lumarko

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Date of Birth

Delivery address

Company (e.g. Google, Inc.)

Identification number^* (DNI / NIF / NIE)

First name^* (e.g. Jack)

Last name^* (e.g. Thompson)

Address^* (e.g. 15 High Street)

Zip / Postal code^* (e.g. 90104)

City^* (e.g. Paris)

Country^*

State^*

Mobile phone^* (e.g. 555-100200)

Additional information

Please use another address for invoice

Invoice address

Company (e.g. Google, Inc.)

Identification number^* (DNI / NIF / NIE)

First name^* (e.g. Jack)

Last name^* (e.g. Thompson)

Address^* (e.g. 15 High Street)

Address (Line 2) (e.g. Room no.304)

Zip / Postal Code^* (e.g. 90104)

City^* (e.g. Paris)

Country^*

Mobile phone^* (e.g. 555-100200)

Payment in advance courier (PayPal, Revolut)

£ 3.72 (tax incl.)

48
(Product concerned: Gosia Amigo Widelce Wielokrotnego Użytku 12 szt 8023..)

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Shopping cart summary

Product	Description	Ref.	Unit price	Qty	Total
	Gosia Amigo Widelce Wielokrotnego Użytku 12 szt 8023.. SKU : GOS000368	GOS000368	£ 0.42 -£ 0.48 £ 0.90		£ 0.42

Total products (tax incl.):				£ 0.42
Total vouchers (tax incl.)				£ 0.00
Total gift-wrapping (tax incl.):				£ 0.00
Total shipping (tax incl.):				£ 3.72
Total (tax excl.):				£ 4.14
Total tax:				£ 0.00
Payment fee
Total:				£ 4.14
Total:				£ 4.14