| Home Address | Ship to | ||
| Name: | Name: | ||
| Street: | Street: | ||
| City: | City: | ||
| State: | Country: | State: | Country: |
| Zip: | Zip: | ||
| Phone: | Phone: | ||
| E-Mail Address: | E-Mail Address: | ||
| Cat # | How Many |
Size | Color | Description | Price Each |
Total |
|---|---|---|---|---|---|---|
| Deduct And Attach Merchandise Certificate(s) | ||||||
| Merchandise Subtotal | ||||||
| (AZ Residents only) Add sales tax: Subtotal x 8.35% | ||||||
| Shipping Charges | ||||||
| ORDER TOTAL | ||||||
| PAYMENT METHOD | |
| Check or Money Order Enclosed | |
| Discover, Mastercard, Visa or American Express | |
| Account Number: | | | | |-| | | | |-| | | | |-| | | | | | Expiration Date: | | |-| | | |
| V-Code - 3 digit Security Code on back of card | | | | | |
| Signature | |
| SHIPPING INFORMATION | ||
| Order Total | Shipping | Notes |
| $25 | $ 6.00 | Street address required for UPS shipment |
| $50 | $ 6.90 | |
| $75 | $ 7.90 | Shipping Charges For Saddles: $25.00 |
| $100 | $ 10.00 | |
| $200 | $ 11.00 | FOB Items: Use UPS Rate Tables - UPS QuickCost (www.ups.com) |
| $300 | $12.50 | --- ORIGIN Postal Code: "86327" |
| $400 | $13.50 | --- PACKAGE INFORMATION: - "Daily Pickups", "Your Packaging" |
| Above $500 | $15.00 | |