DEEPAK SARIN *ORDER FORM*..... www.origindia.com.....*Print a copy.........MAIL OR FAX* to *ORIGINDIA*, 1401,BIRCHWOOD COURT,SAN FRANCISCO,CA-94134,USA Fax 1-270-633-8444.......Phone 1-415-935-5833 Name............................................................................. Address.......................................................................... City.......................................State............Zip.................. Daytime Phone................................cell................................ Email..................................Fax....................................... Check:..................................Money Order:.......................... Visa:.............Master Card:................Discover: ............... Credit Card Number:.................................Security code............ Signature on card:................................................ Please ship the following: item...........................rate .........qty..................$.......... item...........................rate..........qty..................$............. item...........................rate..........qty..................$.............. item...........................rate..........qty..................$.............. item...........................rate..........qty..................$.............. item...........................rate..........qty..................$.............. item...........................rate..........qty..................$.............. item...........................rate..........qty..................$.............. item...........................rate..........qty..................$......................... Total of Value of Items Ordered $............................................ Please note we have a $50.00 minimum order. California Sales Tax (9.25%) $......... Add Sales Tax only if we ship to CALIFORNIA Shipping:-$10.00 For order $50 to $149 above $150 shipping is free Total Enclosed $................................................................ <p><strong><span class="caps">ORDER</span> <span class="caps">FORM</span></strong>&#8230;.. www.origindia.com&#8230;..<strong>Print a copy&#8230;&#8230;&#8230;<span class="caps">MAIL</span> OR <span class="caps">FAX</span></strong> <br /> to <strong><span class="caps">ORIGINDIA</span></strong>, 1401,<span class="caps">BIRCHWOOD</span> <span class="caps">COURT</span>,<span class="caps">SAN</span> <span class="caps">FRANCISCO</span>,CA-94134,<span class="caps">USA</span><br /> Fax 1-270-633-8444&#8230;&#8230;.Phone 1-415-935-5833</p> <p>Name&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.. <br /> Address&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.. <br /> City&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;State&#8230;&#8230;&#8230;&#8230;Zip&#8230;&#8230;&#8230;&#8230;&#8230;&#8230; <br /> Daytime Phone&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;..cell&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;..</p> <p>Email&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.Fax&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;</p> <p>Check:&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.Money Order:&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;..</p> <p>Visa:&#8230;&#8230;&#8230;&#8230;.Master Card:&#8230;&#8230;&#8230;&#8230;&#8230;.Discover: &#8230;&#8230;&#8230;&#8230;&#8230;</p> <p>Credit Card Number:&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;Security code&#8230;&#8230;&#8230;&#8230;</p> <p>Signature on card:&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;<br /> Please ship the following:</p> <p>item&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;rate &#8230;&#8230;&#8230;qty&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;$&#8230;&#8230;&#8230;.</p> <p>item&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;rate&#8230;&#8230;&#8230;.qty&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;$&#8230;&#8230;&#8230;&#8230;.</p> <p>item&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;rate&#8230;&#8230;&#8230;.qty&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;$&#8230;&#8230;&#8230;&#8230;..</p> <p>item&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;rate&#8230;&#8230;&#8230;.qty&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;$&#8230;&#8230;&#8230;&#8230;..</p> <p>item&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;rate&#8230;&#8230;&#8230;.qty&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;$&#8230;&#8230;&#8230;&#8230;..</p> <p>item&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;rate&#8230;&#8230;&#8230;.qty&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;$&#8230;&#8230;&#8230;&#8230;..</p> <p>item&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;rate&#8230;&#8230;&#8230;.qty&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;$&#8230;&#8230;&#8230;&#8230;..</p> <p>item&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;rate&#8230;&#8230;&#8230;.qty&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;$&#8230;&#8230;&#8230;&#8230;..</p> <p>item&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;rate&#8230;&#8230;&#8230;.qty&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;$&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.</p> <p>Total of Value of Items Ordered $&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;..<br /> Please note we have a $50.00 minimum order.</p> <p>California Sales Tax (9.25%) $&#8230;&#8230;&#8230; Add Sales Tax only if we <br /> ship to <span class="caps">CALIFORNIA</span><br /> Shipping:-$10.00 For order $50 to $149 above $150 shipping is free</p> <p>Total Enclosed $&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.</p> 2009-05-10T18:38:01-07:00 order-form 3310542 2009-05-10T18:38:01-07:00 187692 ORDER FORM/ 2009-07-28T01:00:06-07:00