Antique Legacy Order Form

PAYMENT TERMS : Payment is accepted by MASTERCARD, VISA, DISCOVER, Personal or certified check or money order. Credit card sales will be mailed as soon as approval is received. If certified check or money order merchandise will be sent out upon receipt: if personal check it will be held until check clears. We will hold the item for 7 days pending receipt or your check. If check not received after 7 days item will again be for sale. NOTE : Credit card will be billed under the name of Antique Legacy of Colorado Springs Co. Check or money order please submit this order form and sent the check to : ANTIQUE LEGACY 2624 W COLORADO AVE. COLORADO SPRINGS CO. 80904 1-303-404-0591 OVERSEAS SALES: Payment will only be accepted by MASTERCARD, VISA, DISCOVER,or International Money Order in U.S. FundsSHIPPING: Customer will pay for all shipping, handling and Insurance. Co. residents include3% state sales tax unless you have a Co. resale tax number.

All information is kept strictly confidential. We will Email you to verify your order and shipping address. Please provide the following ordering information: Just Tab from box to box do not hit enter or return until you are ready to submit the order.

Name :
Email :

ITEM                DESCRIPTION                     PRICE

              Billing

      Credit Card

Cardholder name

Card number

Expiration date

SHIPPING

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Country

Please provide the following contact information:

Phone

FAX

*Billing*
*Credit Card*
*Cardholder name*
*Card number*
*Expiration date*

	SHIPPING
*Street address*
*Address (cont.)*
*City*
*State/Province*
*Zip/Postal code*
*Country*