Faxable Internet Order Form

Duffys Print & Fax Internet Order Form

Print this form, Complete it and Fax it to (410) 472-3233

Item: _____________________ Quantity:_______ Price:_________

Total:_________

6% sales tax if MD Resident_________

Grand Total:_________

Credit Card # _______________________ NOTE: There is 3% of total amount surcharge for using Credit Cards.

Exp Date ___________ Three Digit Security Code_______

Name ______________________________________

Phone Number: _______________________________

E-Mail Address:________________________________________

Billing Address: ________________________________________

________________________________________

Shipping Address: (If different from Billing Address)

____________________________________________________