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Appeal application (paper form):

Public Office / Archive service:

Revision request (paper form):

Property Number:*

Purchase Code (Alt Ref):*

Description of Goods:*
(Maps or Certificates)*

Amount Payable (in euro):*

Name:*

Email:*

Delivery / Contact Address:*

Cardholder Details

Address Line 1: *

Address Line 2: *

Address Line 3:

City: *

Postal Code: *

Country: *

Phone Number (incl. Country Code):

eg: 353 86 1234 567

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