dBcom Order Form

Order Form

Terms:
• VISA or MasterCard.
• COD available on orders over $500, 25% deposit required.
• CA residents add State Sales Tax.
• Most items in stock - call for delivery time
• Returns subject to restocking fee

Date:

Saturday August 30, 2008

Billing Information

First Name:		Last name:
Email Address:
Street:		City:
State:		Zip Code:
Daytime Phone:		Evening Phone:

Shipping Information - Same as Billing Information

First Name:		Last name:
Street:		City:
State:		Zip Code:
Daytime Phone:		Evening Phone:

Product Information

Item #1:	Model/Part #:	Desc:	Qty:	Unit Cost:	$	0.00
Item #2:	Model/Part #:	Desc:	Qty:	Unit Cost:	$	0.00
Item #3:	Model/Part #:	Desc:	Qty:	Unit Cost:	$	0.00
Item #4:	Model/Part #:	Desc:	Qty:	Unit Cost:	$	0.00
Item #5:	Model/Part #:	Desc:	Qty:	Unit Cost:	$	0.00
Item #6:	Model/Part #:	Desc:	Qty:	Unit Cost:	$	0.00
						$

Payment Information

Payment Type: COD Credit Card

Credit Card Nbr:			Expiration:
Security Code:	( 3-digit number back of card )

Subtotal $
Sales Tax $	(CA orders add 8.75%)
COD Fee $	$12.00 COD Fee
Shipping $		(Standard shipping/handling on orders under $250 add $12.50, for expedited and other rates, please call)

Total $	(Click inside the Total box to total the order))