PLEASE PRINT CLEARLY cal/jam Click Here To Print This Page
California-Antilles Trading Consortium
3735 Adams Ave.
San Diego, CA 92116
Tel/Fax (619) 283-4834
Ordered by:
Name_________________________________________
Address _______________________________________
Apt./Suite No.__________________________________
Phone Number (_____)___________________________
City_____________________State______Zip ________
Ship to: (Use only if different from "Ordered by")
Name _________________________________________
Address________________________________________
Apt./Suite No.___________________________________
City_____________________State______Zip _________
Credit Card Number ___________________________________ (Please Print Legibly!
Please Check Credit Card Type:
Signature X__________________________________________ (necessary for credit card orders!)
| QTY |
ITEM NO. |
DESCRIPTION OF ITEM | PRICE | TOTAL |
| Subtotal | ||||
| Shipments to CA add 7.75% Sales tax to Subtotal | ||||
| Shipping and Handling | ||||
| TOTAL | ||||