Product/ItemQtySizePriceTOTALEx: BootyKing | _______________ | _____________ | ______________ | ___________ | _________ |
_______________ | _____________ | ______________ | ___________ | _________ |
_______________ | _____________ | ______________ | ___________ | _________ |
_______________ | _____________ | ______________ | ___________ | _________ |
_______________ | _____________ | ______________ | ___________ | _________ |
_______________ | _____________ | ______________ | ___________ | _________ |
_______________ | _____________ | ______________ | ___________ | _________ |
_______________ | _____________ | ______________ | ___________ | _________ |
|
Phat Pimp Order Total | ___________ |
| USPS Shipping & Handling: $4.75 | ___________ |
| COD Payment: Additional $10.00US Charge | ___________ | TOTAL Payment AMOUNT | ___________ |
|
Credit Card Payments Billed By:
TRADEMAKERS MN Fax This Form To: 763-574-9228 Please Allow 3-5 Days for Delivery.
Make Checks/Money Orders Payable to: 1306 Poppyseed Drive Suite 3000 St. Paul, MN 55112 |
Please Send Phat Goods To:Name__________________________Address_______________________ City___________State_______ZIP_________ Country____________________ Phone#______________________ E-Mail Address____________________ Billing Info: Name On CREDIT CARD______________________ CREDIT CARD TYPE____________________ CREDIT CARD#______________________ Exp.Date______________________ Signature______________________ |