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JEDCO LEATHER CO.,
P.O. Box-206, Hedley Tx. 79237,
Phone = 806-856-5251, Email= jedco@arn.net, web site = www.jedcoleather.com
** SIMPLY PRINT THIS FORM OFF, FILL IN ALL BLANKS, mail to address above.
ORDER - FORM: (This form is used for MANY varied products. Fill in as
needed.)
Date: _________________
Name_________________________________Phone#_____________________________
Mail Address_______________________________________
City________________________________State_____________Zip_________
Stock#__________________Description/STYLE______________________________
SIZE _________________BODY WIDTH_____________TAPER______________
COLOR_____________________,Single Layer or Lined & Stitched (circle one)
OTHER INSTRUCTIONS_____________________________________________
Base Price =_______
**(Any EXTRA WORK - Charges as listed)
.......................................................=_______
Texas Residents must pay .0725% Tax.................=_______
SHIPPING RATES:
< $1-$50 >=$6.95,
< $51-$100 >=$8.95,
< $101-$200 >=$12.95,
< over 200 >= $16.95,
................................................................................................=_______
Grand Total =_______
Payment - VISA, MC, MONEY ORDER (circle one)
CC #____________________________________________, EXP. Date_____________And
we need the LAST THREE NUMBERS =______________on the back of your CC for
security verification.
Signature of Name on CC ____________________________________(signature
required)
Explain any DETAILS, EXTRAS, SPECIAL REQUESTS, or make a simple drawing if
needed on the back of this order page. CALL us if you still have questions
or problem.
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