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ORDER FORM - Lingerie Lovers/Panty Art

ORDER FORM

California Residents ONLY Add Sales Tax

 ___________________________________________
|   ITEM #   |   DESCRIPTION    |   PRICE   |
|____________|__________________|___________|
|            |                  |           |
|____________|__________________|___________|
|            |                  |           |
|____________|__________________|___________|
|            |                  |           |
|____________|__________________|___________|
|            |                  |           |
|____________|__________________|___________|
|            |                  |           |
|____________|__________________|___________|
|            |                  |           |
|____________|__________________|___________|
|            |                  |           |
|____________|__________________|___________|
|            |                  |           |
|____________|__________________|___________|
|            |                  |           |
|____________|__________________|___________|
|            |                  |           |
|____________|__________________|___________|
|            |                  |           |
|____________|__________________|___________|
                                |           |
                    Mdse. Total |___________|
                                |           |
                    + Insurance |___________|
                                |           |
                      Sub-Total |___________|
               Calif. Sales Tax |           |
                  (sub x .0825) |___________|
                                |           |
                         TOTAL  |___________|

Please PRINT the following information:

Name:_____________________________________________________

E-Mail:____________________________________________________

Address:___________________________________________________

__________________________________________________________

City:_________________________________ State:_____Zip:_________

Country:______________________________

SNAIL MAIL TO:
L L A P A
P.O. Box 8005-W
Emeryville, CA 94662

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