DAVE CHAMBERS
5510 Ptolemy Way, Mira Loma, CA 91752
Telephone # 951-685-3252 FAX # 951-685-7896
Please sign and fax this completed form to 951-685-7896, my dedicated fax telephone line
I ___________________________________authorize Dave Chambers to debit my credit card for the purchase of a Pet Dryer System / Cat Dryer System for the purchase price of $489.95 + 5% non cash difference. If I am a California resident I will add 8 ¾% CA State sales tax to the purchase price. Packing, insurance and shipping to US residents will be $52.50 (on credit card purchase). For Canadian or International orders, I have contacted Dave Chambers by telephone or email and I have received a quote of $____ for shipment to my foreign address.
One Pet Dryer System at $489.95 plus 5% is $514.44.
Shipping of $_______($52.50 in US--including 5%, or email quote for Canadian or International shipments) +
CA State tax (if applicable) of $44.29
For a total of $____________ .
Place "X" next to motor desired: ___ for 110 volt, ___ for 220 volt.
Type of card_____________ (Visa, MasterCard, Discover, or American Express only)
Card number________________
Expiration date of card______________
Card holder name __________________
My name and complete mailing address is ____________________________________________________
Signature_____________________________ PHONE______________________
Your credit card bill will reflect Ragnarok Cattery for this purchase.