|
BILLING
INFORMATION
|
|
SHIPPING ADDRESS
(if different from billing)
|
| Name_________________________________ |
|
Name_________________________________ |
| Address_______________________________ |
|
Address_______________________________ |
| City___________________________________ |
|
City___________________________________ |
| State__________________________________ |
|
State__________________________________ |
| Zip Code_______________________________ |
|
Zip Code_______________________________ |
| Phone__________________________ |
|
Phone_________________________________ |
| Email__________________________________ |
|
Email__________________________________ |
*Please note that only Michigan residents are required to pay the 6%
sales tax. Otherwise, sales tax is not included in total amount of purchase.