Voucher / Gift Card Order Form - Lyoness

Voucher / Gift Card Order Form
Member ID
Mobile Phone Number
Please send the completed Order Form by post to Lyoness Holding Europe AG - Dubai Branch, Emaar Business Park,
Building 4, 6th Floor, P.O. Box 390490, Sheikh Zayed Road, Dubai, United Arab Emirates,
by fax to +971 (4) 43 56 159
or send the scanned image by Email to office@lyoness.ae
ORDER INFORMATION: (All amounts in AED)
RECEIPT OF VOUCHERS / GIFT CARDS
I will collect my order from Lyoness Holding Europe AG - Dubai Branch, Emaar Business Park, Building 4,
6th Floor, Sheikh Zayed Road, Dubai, United Arab Emirates, Tel.: +971 (4) 45 34 343
By Post to my home address given
Minimum order for delivery by courier is AED 1,000. Delivery free of charge.
This order is placed with Lyoness Holding Europe AG – Dubai Branch, a branch of a foreign company duly incorporated under the laws of the United Arab Emirates, registered under commercial license no. 645346, having its address at Emaar Business Park, Building 4, 6th Floor, P.O.
Box 390490, Dubai, United Arab Emirates on behalf of Lyoness Europe AG. This order is subject to the General Terms and Conditions agreed between the Member and Lyoness Europe AG. Lyoness reserves the right to reject or refrain from executing this order without giving reason.
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PAYMENT INFORMATION
Loyalty Partner
(Name/ID)
Payment via bank transfer to my Purchase Account
Payment via credit from my Purchase Account
*Place, Date, Signature of the Member/Authorized Signatory of the Company
*Mandatory: Incomplete information cannot be accepted
Order Value
(Purchase Price)
min.
%
Down Payment /
Partial Payment
TOTAL:
RAK Bank
Account Holder: Lyoness Holding Europe AG - Dubai Branch
Account No.: 0033-338106-061
Swift Code: NRAKAEAK
IBAN: AE650400000033338106061
Lyoness Europe AG
Bahnhofstrasse 7, CH-9470 Buchs, Switzerland
registered as CH-170.3.026.427-4
of the trade registry office of the Canton St. Gallen – main register
On behalf of Lyoness Europe AG:
Lyoness Holding Europe AG - Dubai Branch
Emaar Business Park, Building 4, 6th Floor,
P.O. Box 390490, Sheikh Zayed Road,
Dubai, United Arab Emirates
License No. 645346
Amount
payable
Tel.: +971 (4) 45 34 343
Fax: +971 (4) 43 56 159
Email: office@lyoness.ae
Internal
Booking
AC Number
120620_AE_lyo-coupon-order-pre-payment
N.B.: All sections of this form must be fully completed. Incomplete Order Forms cannot be accepted.

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Information Checklist
By signing below I confirm that I have read and understood the General Terms and Conditions.
Please note, that this order will only be processed by Lyoness when accompanied by a properly completed form.
I understand that Vouchers and/or Gift Cards constitute vouchers of Loyalty Partners and can only be redeemed at the respective Loyalty Partners
shops or locations within the specified validity period. The Vouchers and/or Gift Cards shall be obtained from Lyoness.
I understand that ordered Vouchers and/or Gift Cards will only be sent to me upon receipt of the full purchase value (order value).
I understand that down payments in respect of orders constitute only a part of the total purchase price (order value) and therefore do not result in
vouchers being sent to me.
I understand that in case down payments/partial payments for orders have been made, I can switch the Loyalty Partner up until receipt of the full
payment of the purchase price (order value) at any time, but that this may result in a change in Member Benefits.
I understand that I do not have a right of withdrawal nor a right of refund for down payments/partial payments for orders after the payment has been
received, since the Vouchers and/or Gift Cards triggers an order process between Lyoness and the Loyalty Partner.
I understand that down payments/partial payments as well as the purchase price (order value) do not constitute an investment, but rather a legally
binding sales contract (order).
*Place, Date, Signature of the Member/Authorized Signatory of the Company
N.B.: All sections of this form must be fully completed. Incomplete Order Forms cannot be accepted.