Print and Fax to: (323) 290-5398
| INVOICE | ||||||||||
| Customer | Misc | |||||||||
| Name | ____________________________________________________ | |||||||||
| Address | ____________________________________________________ | |||||||||
| City | ___________________ | State | _____ | ZIP | ________ | |||||
| Phone | ||||||||||
| Qty | Item Number | Description | Unit Price | TOTAL | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| _____ | ___________________ | ___________________________________________ | $_______ | $___________ | ||||||
| SubTotal | $___________ | |||||||||
| Shipping |
$___________ |
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| Payment | Tax Rate(s) | |||||||||
| ___________________________________ | ||||||||||
| Comments | TOTAL | |||||||||
| Credit Card | ___________________________________ | |||||||||
| Name | ___________________________________ | |||||||||
| CC # | ___________________________________ | Office Use Only | ||||||||
| Expires | ___________ | |||||||||
| Card Number | (3 or 4 digits usually located on back of card): | |||||||||
| Please allow up to 2 weeks for
delivery Thank you for your Business!!! |
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