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<html>
<head>
<title>BBLingerie Print Order Form </title>
</head>
<body BGCOLOR="FFC4E4">
<table border="0" cellpadding="0" cellspacing="0" width="600">
<tr>
<td><p align="center"><img src="images/Bblogo.gif" alt="Bblogo.gif (4445 bytes)" WIDTH="258" HEIGHT="53"><br>
<b>FAX/Mail Print Order Form</b></td>
</tr>
<tr>
<td><br>
We accept <img src="images/ccanim.gif" alt="ccanim.gif (2314 bytes)" WIDTH="56" HEIGHT="35"> and <img src="images/discover.gif" alt="discover.gif (2623 bytes)" WIDTH="64" HEIGHT="39"><br>
Print and FAX with your credit card order information to: .<br>
Or, Print and MAIL this order form with your payment to: <br>
BB Lingerie, Costa Mesa, CA , USA<p>PLEASE PRINT CLEARLY </p>
<p>NAME: _________________________________________________________________ <br>
ADDRESS: ______________________________________________________________ <br>
CITY: ________________________________ STATE: ____ ZIP: __________________ <br>
EMAIL ADDRESS: _______________________________________________________<br>
PHONE NUMBER: _________________________________________</p>
<p>ITEM NUMBER/COLOR/SIZE...........PRICE PER ITEM.........QUANTITY................TOTAL <br>
___________________________...._________________....__________................__________ <br>
___________________________...._________________....__________................__________ <br>
___________________________...._________________....__________................__________ <br>
___________________________...._________________....__________................__________ <br>
___________________________...._________________....__________................__________ <br>
___________________________...._________________....__________................__________ <br>
___________________________...._________________....__________................__________ <br>
___________________________...._________________....__________................__________ <br>
___________________________...._________________....__________................__________ <br>
...........................................................................................................SUBTOTAL:
__________ <br>
................................................................CA residents MUST add
8.25% sales tax:.__________ <br>
.....Shipping: USA $6.95 FedEx/UPS; Canada $9.95 SUPS; Int'l $14.95 USPS: ___________ <br>
...............................................................................................................TOTAL:
___________</p>
<p>Accepted Methods of Payment: VISA, MasterCard, and ALL US$ Checks. Make checks payable
to <i><b>BB Lingerie</b></i>. </p>
<p>Credit Card Type: ___VISA or ___MasterCard<br>
Name on CC: ________________________________________<br>
Card #: __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __&nbsp;__&nbsp;__&nbsp; Expiration
Date: __ / _____</p>
<p>SIGNATURE: _____________________________________________________________ </p>
<p>Date of order __ / __ / _____ </td>
</tr>
</table>
</body>
</html>