JCS BARGAIN Mail/Fax Order Form

Please check the addresses for Accuracy. You are responsible for all charges billed by UPS for returns due to inaccurate addresses and for a 15% restocking fee for returns. UPS does not ship to P.O. BOXES

SOLD TO:   SHIP TO:
Name:   Name:
Address:   Address:
City:   City:
State:   State:
Zip:   Zip:
Email:   Email:
  QTY DESCRIPTION MODEL # PRICE
1        
2        
3        
4        
5        
6        
7        
Sub-Total:  
Michigan Sales Tax
if shipping to Michigan
+ 8.3%
Sub-Total2:  
Shipping & Handling:
See Instructions below
 
Grand Total  

Shipping Fees
$5-----6.00
$10-----8.50
$20-----12.00
$30-----15.00
$40-----17.00
$50-----20.00
$60-----22.00
$70-----26.00
$80-----29.00
$90-----31.00
$100-----34.50
$200-----35.00
$300-----37.00
$400-----40.00
$500-----45.00

If you need more than 7 items use additional sheets.

TEXAS SALES TAX: Orders shipped to Texas will be charged 8.3% sales tax. If you are not shipping to Texas leave this field blank.

Mail the above order form and your check or money order made out to:

JCS Bargain
13275 Benchmark Drive, Farmers Branch, TX 75234