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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