Order Form
Mail To:
Blade Runner Fishing Tackle
76 River Road
Hammond, NY 13646
Fax To:
315-324-6603
Call:
315-324-6603
Name: ______________________________________ Phone:__________________________________
Address: ______________________________________________________________________________
City: _________________________ State: ______________________ Zip:________________________
(Attach another sheet if needed)
Shipping & Handling:
$0 - $20: $3.95
$20-$50: $5.95
$50-over: FREE
Merchandise Total: ______________________
Shipping & Handling: ____________________
New York Sales Tax:______________________
(New York Residents only 7%)
Total: _________________________________
Method of Payment
___Check/ Money Order _____Masstercard ___VISA
Expiration Date:_________________ Security Code (3 Digits on back of card):________________
Charge Card Number: _____________________________________________
Cardholder's Signature:____________________________________________
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