PrimitiveDecorWholesale.com
HugsAndStitches.com
~Please completely fill out the information below and fax to 888-522-7140~
~*~Please note: Shipping charges will be added after your order has
been packed and weighed~*~
**Billing Address & Payment Information**
If paying by credit card the address listed here must match the address on
your credit card statement
Name: | |
Address: | |
Address: | |
State, Zip: | |
Phone Number: | |
E-Mail: | |
Payment (Circle): | Visa/ MC Discover AMX *NO Personal or Business Checks, They Will Be Voided and Returned* |
Credit Card # : | |
Expiration Date: | |
CVV2# (3 digit # on back): | |
Signature: |
**Shipping Address**
If different then billing address
Name: | |
Address: | |
Address: | |
State, Zip: |
~*~Please note: Shipping charges will be added after your order has
been packed and weighed~*~
~*~Please Be Sure To Include the Item Number & Quantity For
Each Item Ordered~*~
All Michigan Orders Must Include 6% Sales Tax
Quantity |
Item Number |
Description |
Price Each |
Total |
Sub Total |
------------> | |||
Michigan Residents add 6% Sales Tax |
------------> | |||
Order Sub Total BEFORE Shipping |
------------> |
(o: Thank you for your order, we will e-mail you your order total with shipping and the
date your order will ship :o)