Please Print This Page  fill in the lines and Mail it with a money order or Check to

Adura Pty Ltd
PO Box 43407
Casuarina NT 0811

Tax Invoice Date

Your Name:________________________________________

YOUR Address_____________________________________

Postal Address______________________________________

Your Town:___________________________________( You will have sole rights to our system for this area only)

Your Phone_________________________________________

Your Fax___________________________________________

Your Email__________________________________________

Ammount $6995 GST Inc

Payment Deatils:

Check: Made Out To Adura Pty Ltd Takes 5 Days To Clear

Money Order: Made Out to Adura Pty Ltd (Instant as soon as Cleared)

Bank Transfer: Bank = National Australia 
Account Name = Adura Pty LTD 
Account Details = BSB: 085-933
ACCOUNT: 48-874-6083
Payee Details = (include your name as payee)

Credit Card: ( Licence Required 3% Surcharge)
Card Number:______________________________________
Name On Card_____________________________________
Expirey:___________________________________________
Ammount Authorised:________________________________
Signature:________________________________________

 I understand there is a $250 Dollar Yearly fee payable on each yearly anniversory this fees must be paid within 30 Days of recieving a bill, failure to pay requires me to stop using Body Bits Name and also removal from the website. X_______________________________ I am Over 18.