Foundation for Intelligent Physical Agents
c/o Me Jean-Pierre Jacquemoud
2, rue Bellot
CH-1206 Geneve
SWITZERLAND

Pro-forma invoice

Company Name  
   
Address  
   
City of Headquarters  
   
Date and details  
of payment  
Annual membership fees for

01 July 1998 - 30 June 1999

Swiss Francs 3,500.00

Note: Please make sure that payment is

  1. made in Swiss currency
  2. free of bank charges
  3. and to:

CBG-Compagnie Bancaire Geneve
21, Rue du Rhone
CH-1204 Geneva
SWITZERLAND
Account no.: 1.122'920
Reference: "FIPA"

When payment has been made please send this form to:

Dr. Leonardo Chiariglione Tel.: +39 11 228 6120
CSELT Fax: +39 11 228 6299
Via G. Reiss Romoli, 274 Email: leonardo.chiariglione@cselt.it
10148 Torino (ITALY)