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*Indicates Required Field * * * * City State/Province/Prefecture Country ZipCode/PostCode * * RIX CORPORATION INTERNATIONAL BUSINESS DEPT. 1-15-15 SANNO HAKATA-KU FUKUOKA 812-8672 JAPAN TEL: 81-92-472-7312 FAX: 81-92-475-2983 E-Mail:rixibd@rix.co.jp