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Products to order

Contact / Billing Details

Required fields:

Contact person

Company name

Company address

Company address line 2


ZIP/Postal code



Telephone number

E-mail address

Shipping Address

Required when the shipping address is different than the contact details:

Ship to contact person

Ship to company name

Shipping address

Shipping address line 2

Ship to City

Ship to ZIP/Postal code

Ship to state

Ship to Country

Ship to Telephone number

Ship to E-mail address

Shipping Instructions

When you want to use your own shipping account

Desired delivery date

Declared value for customs purposes in U.S. Dollars or Euros

NOTICE: If you live outside the USA and you enter a Declared Value in this text box, Pangolin requires you to understand and abide by the customs procedures and regulations applicable for your country. The value that you enter in this box is related to customs duties and taxes that may be assessed when you receive the package. Entering an incorrect value in this box may delay package arrival or, in some cases, trigger penalties for entering the wrong amount. When in doubt, you should specify the same value that is used in the Total Payment Amount box below.

Additional instructions


Payment Method
 Credit Card Paypal Wire Transfer Other
Cardholder name

Cardholder billing address and telephone number

Card type
 Visa MasterCard American Express
Card number

Expiration date

Security Code