Stacy Vosberg Fine Art Paintings & Priints : Fax Order Form

S T A C Y V O S B E R G F I N E A R T

Use the form below to place an order by fax, using your credit card. Print a copy of the blank form, then fill it out and fax it to Stacy Vosberg Fine Art. Retain the original. Your order will be confirmed by e-mail within 48 hours.

We ship via UPS Ground. There is a $20.00 flat-fee shipping charge for each order of up to 5 paper prints. This covers packing materials and shipping fees to any domestic US address including Alaska and Hawaii. There is no handling charge. Extra charges for shipping of international orders will be calculated separately and included in your email order confirmation.

Fax your order to: 805.210.2681

*Date*	.			.
	.
Your Name

*Credit Card Information*	To Use: Fill In Card Type, Card Number, and Expiration Date Below
*Cardholder*	.
*Signature*	.
*Billing Address*	.
*Street*	.
*Street 2*	.
*City Name*	.
*State / Prov.*	.
*Country*	.
*Zip Code*	.
	.
*Telephone*	.
*FAX*	.
*Email*	.

*Ship Address*		.	*Same As Above*
Name	.
*Street*	.
*Street 2*	.
*City Name*	.
*State / Prov.*	.
*Country*	.
*Zip Code*	.

	Print *Title*					*ID Number*	Price
Print 1	.
*Print 2*	.
*Print 3*	.
*Print 4*	.
*Print 5*	.
Sales Tax	CALIFORNIA RESIDENTS ONLY - PLEASE ADD 7.75%				.
Shipping Fee							20.00

	*Total Purchase Amount*.

*Notes and Special Instructions*	.