Date __________________
BUYER:
Name (print) __________________________________________________________________
Mailing Address __________________________________________________________
City, State, Zip Code, Country________________________________________________________________________
Phone Number _______________________ E-mail address _____________________________
COMMISSIONED BY (if
applicable):
|
|
|
|
| 1. | ||
| 2. | ||
| 3. | ||
| 4. | ||
| 5. | ||
|
SUBTOTAL |
||
|
California
residents only, |
||
|
Shipping
& Handling |
||
|
TOTAL DUE |
|
|
|
|
|
| Up to 30.00 |
|
91.00 -120.00 |
|
|
| 31.00 - 60.00 |
|
121.00 -150.00 |
|
|
| 61.00 - 90.00 |
|
151.00 -180.00 |
|
Make a check (check must have a United States address), money order, or cashier's check (U.S. dollars) payable to: Dino Labiste
Any questions, contact Dino Labiste at e-mail KahikoArts@yahoo.com or call (510) 494-9297 .