Cutlery Cuts Order Form Billing Information Shipping Information (if different) Name________________________________ Name ______________________________ Address __________________________ Address _____________________________ City_______________________________ City_________________________________ State/Zip__________________________ State/Zip____________________________ Phone_____________________________ (incase of any questions) Email _____________________________ (required for confirmation) Method Of Payment _____Visa _____Master Card Credit Card Number ______________________________ _____Discover _____AMEX Security Code _________ Expiration Date ____________ (back of card) _____Check / Money Order __________________________________________________ Signature _____Cash (at your own risk) Product Quantity Description Price _______ ________ _____________________________________ __________ _______ ________ _____________________________________ __________ _______ ________ _____________________________________ __________ _______ ________ _____________________________________ __________ _______ ________ _____________________________________ __________ _______ ________ _____________________________________ __________ _______ ________ _____________________________________ __________ _______ ________ _____________________________________ __________ _______ ________ _____________________________________ __________ Less than $35.00 = $6.95 Sub-total: __________ $35.01 to $50.00 = $8.95 $50.01 to $75.00 = $10.95 CA Taxes: __________ $75.01 or more = FREE SHIPPING! Total: __________ Mail to: FAX: 619-955-8991 Cutlery Cuts PO Box 84882 San Diego, CA 92138