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Alternatively, you can also make the payment using our PDF Form!



Your Data



Company / Institute


Department


Firstname and Surname *


Street *


ZIP Code / City *


E-Mail *


Customer Number




Payment and Credit Card Information



Firstname and Surname of Cardholder *


Card Type *


Card Number *


Card Expiration Date *


CVV/CVC Number *



Invoice Number(s) *


Amount in € *



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Consent:
By ticking the checkbox, you agree that the data you provide will be collected and stored electronically. Your data is used only for the purpose it was provided (processing your payment). You can revoke this consent at any time by message to us. The revocation must be sent by e-mail to: info@cs-chromatographie.de, or by mail to: CS-Chromatographie Service GmbH, Am Parir 27, 52379 Langerwehe, Germany. Upon receipt of the revocation, we will no longer use the data in question and process or delete it. For further information, please refer to our privacy policy.


For privacy reasons, you will not receive a confirmation e-mail. An invoice will be sent to you in a separate form.