Advertisement
Attn: Individual Returns
47-50 33rd Street
Long Island City, NY 11101
(718)-729-8890
Battery
Case
Bezel
Band(Polyurethane)
Band(Metal)
Band(Nylon)
California residents add
7.25% tax
Processing and handling
Total
Check or Money Order
Master Card
Visa
__________________________________
Account#
__________________________________
Printed Name
__________________________________
Address
__________________________________
__________________________________
__________________________________
Phone Number
__________________________________
Signature
$ 4.00
10.00
6.00
12.00
20.00
7.00
8.50
________
$
Expiration Date
901004-1-2
Advertisement
