| Send Order to:
Painted Mermaid Gallery
or FAX to (207) 743-7312 Date: Store Name___________________________________________________________Phone#____________________________________ Contact_______________________________________________________________Position___________________________________ Address (shpg)__________________________________________________________________________________________________ City____________________________________________________________________State______________Zip__________________ State Tax Resale or State ID#______________________________________________________________________________________ |
| Item | Quantity | Description | Size | Price | Total |
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Credit Card Information The Painted Mermaid accepts: American Express - Visa - Mastercard by phone. Please call (207) 743-7312 for credit card orders We accept Credit Cards,
Checks and Money Orders. ALL ORDERS MUST BE INSURED |
Sub Total | ||
| (Shipping, Handling, Insurance) |
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| 5% Tax ME only | |||
| Total |
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If Faxing Order Complete the
Following for Credit Card Orders: Signature of Card Holder_________________________________________________________________________________ |