ORDER FORM

                                 chuckanddeb.com               

                                                                  302 W.CARMEAN
                                                                  OHIO CITY,OHIO 45874
SHIP TO

NAME_____________________________________________

ADDRESS__________________________________________

CITY_______________STATE_____________ZIP__________

Text Box: TOTAL MERCHANDISE
QUANTITY                DESCRIPTION                         PRICE EACH       TOTAL  

 
 
 
 
 
 

Text Box:  
 

                                                                                                              

Text Box:  
Text Box: OHIO CUSTOMERS ADD 7.5% sales tax

 

Text Box: shipping cost
.01-6.95 is 3.00
6.96-19.99 is 5.00
20.00-49.99 is 6.50
50.00 - 79.95 is 8.50
80.00 and up is 10.00
Text Box:  
Text Box: SHIPPING find shipping cost in the box to your left
 

Text Box:  
Text Box: TOTAL OF ORDER 
I only except money orders and cashiers checks, make checks payable to Charlie Bigham and mail  to Charlie Bigham 302 W.Carmean, Ohio City,Ohio 45874