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GENERAL INFORMATION

Name:	Company:	Position:
Address:	City:	Country:
Zip code:	Phone for contact:	Fax:
E-mail:	Site:
EXCLUSIVE INFORMATION FOR CLIENTS

• Stones you want to buy:
Alexandrite Amethyst Aquamarine Chrysoberyl Emerald	Imperial Topaz Quartz Rhodolite Rubellite Topaz	Tourmaline Rare Gems Which ones:

• Kind:
Rough Cut	Calibrated Free size

• Formats:
Oval Round	Rectangular Fantasy	Others:

• Sizes:	• Additional information:


• Are you interested in receiving updated information by e-mail about rare gemstones offered by Duarte & Bastos? yes no

• If you wish to come to Brazil, indicate which services you would like to use:
Shuttle from Belo Horizonte international airport to Teófilo Otoni; Car Rental; Hotel Reservation; Ticket Reservation on domestic or international flights; Contracting services such as translators, lawyers, guides etc.; Pre-selection of goods; Assistance in the bureaucratic procedures required for transporting goods in and out of the country.
EXCLUSIVE INFORMATION FOR ROUGH STONES SALESPEOPLE

• Rough stones you want to sell:
Alexandrite Amethyst Aquamarine Chrysoberyl Emerald	Imperial Topaz Quartz Rhodolite Rubellite Topaz	Tourmaline Others Which ones:

• Further information on the lots:

INFORMATION REQUEST

• If you haven't obtained all the information that you wished in our site, please write your questions in the box below:




I MAIN MENU I I HISTORY I PROFILE I OFFICE I PRODUCTS I RARE GEMS I ABOUT BRAZIL I I CUSTOMER SERVICE I EXIT I SITE MAP l I WE BUY ROUGH STONES I HOME

Duarte & Bastos has prepared this form for the purpose of facilitating contact between
the company and its clients and suppliers. Simply complete the fields relevant to your specific interest. But if you prefer, send us an e-mail. We thank you for answering our form and ask you to kindly await our response.

D U A R T E & B A S T O S