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BILL TO:
Name: _________________________
Address: _______________________
City: ___________________________
State : _____________ Zip: ________
Phone: (_____)___________________
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Ship TO:
Name: _________________________
Address: _______________________
City: ___________________________
State : _____________ Zip: ________
Phone: (_____)___________________
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Item #
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Item Name & Description
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Skin Tone
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Eye Color
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Kit Style
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Price Each
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Total
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Subtotal
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Shipping & Packing
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Florida Residents, Please add 6% Sales Tax
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Postal Insurance
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Less Any Applicable Coupons or discounts.
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Code #
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Less Deposit
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Order Total
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Payment Form
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Shipping, Packing
& Insurance
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[ ] Check
[ ] Money Order
Please Make Payable to: Diana Jenkins, Owner
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[ ] Credit Card
CC #: ______________________
Expiration : ____________
Signature: ____________________
(required)
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[ ] Lay Away/Order Deposit
only 20% down
Deposit Enclosed:
Balance Due:
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Shipping & Packing:
If Not Listed with doll,
please add 11% of subtotal.
Postal Insurance:
Required on all porcelain products & optional on all else.
Based on subtotal amount, $1.10 X ea. $50
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