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MAIL IN ORDER FORM.
Use this ORDER FORM to mail in a check, cash or cashiers
check. Fill it out completely then
print the form and mail form and payment to:

S. Horbatenko
P.O. Box 2588
Kingsland, GA 31548

YOUR INFORMATION:

Phone With Area Code........

Phone 2 With Area Code.....

Fax #.......

Name .......

Address ..

City...........

State.......

ZIP.............

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Quantity Item# and Size

Item Price Total

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Quantity Item# and Size

Item Price Total

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Quantity Item# and Size

Item Price Total

__________________________________________________

Quantity Item# and Size

Item Price Total

__________________________________________________

Quantity Item# and Size

Item Price Total

__________________________________________________

Quantity Item# and Size

Item Price Total

__________________________________________________

Quantity Item# and Size

Item Price Total

__________________________________________________

Quantity Item# and Size

Item Price Total

__________________________________________________

Add all Totals from Total boxes above

Shipping add 10% to total amount

TOTAL ORDER.....................................

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Make out cashiers check, cash or money order for above total. Make out check to:

S. Horbatenko.


REMEMBER THIS FORM NEEDS TO BE MAILED. PLEASE DO NOT FORGET TO INCLUDE PAYMENT.

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Additional comments for SHIPPING DEPT,
and any other information you feel may
be necessary. Enter this below.

Email SPECIALTY JEANS


NOTE!� Make payment out to S. Horbatenko.

ORDERS PAID WITH A PERSONAL CHECKS MAY BE HELD
UNTIL CHECK CLEARS. It is always faster to pay with
cashiers check, money order or by wire transfer. If you wish to pay by wire transfer (by far the fastest method),
email to the email address above and let us know
that you have wired your funds.

There is a $10 bank fee that you will need to add to your
order before wiring. In order to purchase by wire
transfer, go to your bank with our bank information
and tell them you wish to send a wire transfer to
our bank. If you choose to pay this way, email us
and we will provide our bank information to you.

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