No Graphics Order Form

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)