Iraqi Dinar – Dinar

Tampa Dinar LLC Sales form

This is to certify that ___________________________________________(your name) is

Selling _____________________________(quantity) Iraqi dinars to Tampa Dinar LLC

At the Selling price of _________________________

Quantity of dinars you are selling: __________________________________

Please fill out the following information completely

Payment Method(Circle one): Check via Fedex ($15 Fee)   Check Via Mail (free)  We no longer do wire transfers

Full Name: __________________________________________________________________

Social Security Number:(Payments over $999)______________________________________________________

Phone number: ______________________________________________________________________________

Your Email Address: __________________________________________________________________________

Your Mailing Address: __________________________________________________________________________

Send this form with your dinars to the following address:

_____________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Tampa Dinar LLC,

Signature___________________________________________________

Full Name___________________________________________________

All payments are sent out within 3-5 days from the time we receive your dinars.

Please mail all Dinars to address 364 East Main St.Suite 411 Middletown, DE 19709