LPK International Co., Inc

ORDER FORM

Please fill and print it, return it to us, Thank!

LPK International Co., Inc.	Date:_____________
2233 W. Division	Fax orders to: 817-861-0169 (FAX)
Arlington, Texas 76012, USA	Most orders shipped USPS priority mail (USA Only)

Ship To:
_________________________________________NAME ( First, Middle, Last )
_________________________________________SHIP TO STREET ADDRESS
_________________________________________ADDRESS
____________________________CITY__________STATE______________ZIP
__(__________)____________________________Day time Phone Number

Item #

Item Qty.

Name of Item.

Color-Size.

Price per Item.

Total price.

___________________________________________________________________________

Sub Total

_______________

SALES TAX 7.75% Texas residents only

_______________

SHIPPING AND HANDLING $4.95.00 ON ALL ORDERS U.S.A. (US Post Priority mail)

Shipping and Handling(USA Only)
   $4.95 for 1-2 pc
   $5.75 for 3-5 PC
   $0.50 additional each for the 6th set and more

Others more. Additional Next day Fed-Ex available, extra cost.

_______4.95___

ALLOW 4-5 DAYS FOR DELIVERY -
PERSONAL CHECK, MONEY ORDERS, CASHIERS CHECK ACCEPTABLE

ALLOW 24-48 HRS FOR DELIVERY -
WITH VISA OR MASTER CREDIT CARD

TOTAL

_______________

MasterCard

Visa

Write Credit Card Number In Boxes To left

Exp. Date

_____/____

Print Name as on Credit Card:______________________________

By checking this check box, I declare the above Info. is true and correct. I understand that credit card fraud is a felony.

Signature:__________________________________________

Is the ship to address above the same as the credit card billing address? If not please fill in below.

Address___________________________________________

City______________________State_____Zip_____________

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