Doctors Photographs copy order form - State Records NSW

srecords@records.nsw.gov.auPO Box 516 Kingswood NSW 2747Tel 02 9673 1788 Fax 02 9833 4518ABN 96 588 554 718www.records.nsw.gov.auDoctors’ Photographs copy order formState Records aims to produce reference copies of State archives through the copying services.This is a copy service for the record series NRS 9873, Doctors' photographs.Schedule of feesEach photograph $8.00You will receive a 600dpi jpeg digital image on CD, and a 4’x6’ print on photographic paper.Administration fee $15.00Postage/handling $10.00.Overseas orders additional $3.65 postage.Credit card processing surcharge fee 0.4% of total order.OrderingPrint out the form below, fill in all the details and mail/fax to:Doctors’ Photographs Copy ServiceState RecordsReprographics OfficerPO Box 516 Kingswood NSW 2747Facsimile (02) 9833 4518We accept Visa and MasterCard. Payment may also be made by direct deposit. See StateRecords NSW account details on final page of copy order.Cheques or money orders should be made payable to State Records. We cannot acceptpersonal cheques from foreign banks.Time to complete ordersConditionsPlease do not send cashOrders are despatched within 20 WORKING DAYS of receiving order and payment.Orders with multiple entries may take longer.Copies may not always be legible in cases where handwriting is poor or faint, or theoriginal record is in poor condition.State Records cannot accept responsibility for copies lost in the postal system.State Records does not accept responsibility for photographic orders lost in the postalsystem.Western Sydney Records Centre143 O’Connell Street, Kingswood

State Records NSW — Doctors Photographs photocopy orderYou must provide the FULL name and item detail for each entryPhoto Details 1 = $8.00Name *required:Item number *required:Name *required:Item number *required:Name *required:Item number *required:Name *required:Item number *required:Name *required:Item number *required:Name *required:Item number *required:Name *required:Item number *required:Name *required:Item number *required:Name *required:Item number *required:Photo Details 2 = $8.00Photo Details 3 = $8.00Photo Details 4 = $8.00Photo Details 5 = $8.00Photo Details 6 = $8.00Photo Details 7 = $8.00Photo Details 8 = $8.00Photo Details 9 = $8.002

State Records NSW — Doctors Photographs photocopy orderYour address and payment detailsName:Address:Suburb: Postcode: State:Country (if not Australia):Telephone:Email:Cheque/money order enclosed:Credit Card Number: __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __Credit Card Name:Card Expiry Date: Visa: Mastercard:DeclarationI have read and agree to the conditions aboveI will obtain the written permission of State Records if I wish to publish State archivesor extracts therefrom (See Archives In Brief 11)I accept the credit card processing surcharge fee of 0.4% of total order (credit cardpayments only)I agree:Signature: ______________________________Date: ___________PAYMENT BY DIRECT DEPOSIT:State Records NSWBSB 032-001 Account No 205522Payment reference: Your fullname and postcode.Paid by direct depositDate paidPlease send your order formindicating you have paid bydirect deposit to StateRecords NSW. We cannotprocess your order without it.Cost of orderAdministration fee $15.00Copies $Postage and handling $10.00Overseas order(add $3.65)Total of order:For credit card payments only please addCredit card processing surcharge 0.4%(multiply total of order by 0.004)Final total:3