Mike Lull Custom Guitars Fax Order Form

13240 NE 20^th St. Suite #2 Bellevue, WA 98005 (425)643-8074

FAX COMPLETED FORM TO:

(425) 746-5748

Name and address on Credit card	Ship to: (if different from billing)
Name
Address
Phone
Email

Phone number and email are very important if we need to contact you about your order.

Note: Grand total does not include shipping. We will ship via FedEx ground. If you have a preference, please indicate your choice.

□ UPS Ground □ UPS 3 Day □ FedEx 2 Day □ FedEx Overnight

Select Payment Method: □ VISA □ MasterCard □ American Express

Card Number		V-Code
Expiration Date	Authorized Signature

About the V-Code: For online transactions, we require the V-Code on your card to complete the transaction.

· On VISA and MasterCard, the V-Code is a 3 digit number located on the BACK of the card, and is printed on the right hand side of the signature strip.

· On American Express, the V-Code is a 4 digit number located on the FRONT of the card, just above and to the right of the embossed account number.

QTY	DESCRIPTION		SIZE	EACH	TOTAL
				SUBTOTAL
		WASHINGTON STATE RESIDENCE ADD 8.8% SALES TAX
		TOTAL DUE (SHIPPING CHARGES WILL BE ADDED TO THIS AMOUNT)

THANK YOU FOR YOUR BUSINESS!