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| ORDER FORM | ||||
| Phone: | Date: | |||
| Email: | ||||
| CREDIT CARD BILLING ADDRESS | SHIPPING ADDRESS | |
| CREDIT CARD INFORMATION | ||||
| Credit Card Type: |
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| Card Number: | ||||
| Expiration Date: | CVV2 Number: | |||
| Your Signature: | ||||
| Quantity | Item | Description | Color | Size | Item Price | Extended |
| I. Item Sub Total | ||||||
| II. Shipping Charge | ||||||
| III. Order Sub Total (I + II) | ||||||
| IV. Sales Tax (GA Only, 6% of III) | ||||||
| V. Order Total (III + IV) | ||||||
| TheLingerieConnection.net | 5885 Cumming Hwy | Suite 108-358 | Sugar Hill, GA 30518 | Phone: 877.852.7355 | FAX: 866.904.6533 |