SCREECH OF THE DECAPITATED

ORDER FORM

3Runes Productions llc

10153 ½ Riverside Drive #341/ Toluca Lake, CA 91602

Tel: (818) 207-6405 Fax: (818) 953-7131

Email: screechinfo@yahoo.com

3RUNES ORDER NUMBER: 05-000__

Name:	Order Date:
Phone:	Order Placed By:
Fax:	Email:
Address:	Ship To (if different than “Address”):

ITEM #	ITEM DESCRIPTION	COLOR	SIZE	QTY	PRICE EACH	PRICE TOTAL
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A

Merchandise Total: _____________________

Shipping & Handling (USPS): $4.95 + $1 for each additional item): _____________________

OR Shipping & Handling (FedEx or UPS): _____________________

SubTotal: _____________________

Discounts / Coupons: _____________________

Local Sales Tax: INCLUDED IN PRICE

Grand Total: _____________________

Comments / Special Handling (All items shipped USPS Priority Mail; any other shipping or handling may incur additional charges):

For 3RUNES USE ONLY

Order Taken By: JK __ DK __

Date Received:

Confirm Date: email ___ fax ___ phone ____

Paid _____ Bill ______

Ship Date:

2d Ship Date: