Print-able Order form

PRINT THIS ORDER FORM AND MAIL WITH PAYMENT INFORMATION TO: Jus B'cuz Primitives 498 Lehigh Station Road West Henrietta, New York United States 14586 Phone #: 585-359-2221 Fax #: Email: Sommer@jusbcuzprimitives.com
Circle Payment Method: Check Money Order
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Address:	Email:
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Telephone:	Signature:_____________________

Item Name and Description	Quantity	Price














Subtotal:
Shipping and Handling:
New York residents must add 8.25% sales tax-
MAKE CHECKS PAYABLE TO: Jus B'cuz Primitives	Total :

Thank you for shopping at Jus B'cuz Primitives.