collectorscorner.org store: Printable Coin Supply Order Form: REV.-7/1/20113
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PLEASE PRINT ---- _E-Mail Address: _____________@_____________________ NAME:_______________________________________________ ADDRESS:____________________________________________ CITY:____________________________STATE:___________________ZIP:__________________ Surplus Inventory Order Form |
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| ITEM NUMBER | DESCRIPTION | QUANTITY | PRICE@ | ||
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| SUB-TOTAL___________ | |||||
| N.J Residents, please add 7% sales tax on orders ___________ | |||||
| SHIPPING & HANDLING: see below Left ___________ | |||||
| Map & Oak Frame Orders: Weight & Oversized add Extra $2.00___________ | |||||
| OUT of U.S.A. (Canada $20.00) Over Seas ($50.00) + Standard postage above___________ | |||||
| ( _ ) Check - - ( _ ) Money Order--or Credit Card: type Visa ( _ ) Master Card ( _ ) Amer. Express ( _ ) | |||||
| cc# __________-__________-__________-__________, | |||||
| exp date: _______/_______, security code: ________, Signature:________________________________________ | |||||
| U.S Funds Only:.......TOTAL INCLOSED_______________ | |||||
| ON-LINE ORDERS: E-mail us your order and make a Credit Card payment to our pay-pal account, just be sure to add in the postage.. | |||||
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