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Order Form
Mrslinskitchen Order Form

Bill To
Name:
____________________________
Address:
____________________________
____________________________
____________________________
City:
____________________________
State:
______________ Zip:_____________
Country:
____________________________
Phone:
(_______)___________________
Email:
____________________________
Ship To
Name:
____________________________
Address:
____________________________
____________________________
____________________________
City:
____________________________
State:
______________ Zip:____________
Country:
____________________________
Phone:
(_______)____________________
Email:
____________________________


Signature
__________________________
Date
____________
How do you learn about Mrs Lin's Kitchen?
_________________________________
Special Instruction
_________________________________
_________________________________
_________________________________
Method of Payment
___ VISA ___ Official Money Order
___ Mastercard ___ Cashier Check
___ AMEX    
Credit Card Information
Credit Card Number
________-________-_______-_______
Expiration Date:_________ /_________
Card Security Code (CVV): ___________
Shipping Method
___ Standard
___ Expedited
___ Express
___ AK, HI & US Territories




MY ORDER (S)
Item #
Item name
Unit Price
Qty
Total Price
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
Orders shipped to California, please add the following sales tax:
For Contra Costa County addresses, please add 9.75% sales tax.
(Cities in Contra Costa County: Alamo, Antioch, Bay Point, Brentwood, Central/Pleasant Hill, Clayton, Concord, Crockett, Danville, El Cerrito, El Sobrante, Kensington, Lafayette, Martinez, Moraga, Oakley, Orinda, Pinole, Pittsburg, Rodeo, San Pablo, San Ramon, Walnut Creek & Ygnacio Valley).
For non-Contra Costa County addresses, please add 8.25% sales tax.
Total Purchase
$
Shipping & Handling
$
Applicable Sales Tax of Subtotal
$
Total Due
$

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