Purchase Order Form

Logo Street #2 Tax Discount P.O. # Purchase Order Form <> <><> My Family Shops U.S.A. 4696 Fisherman's Cove Montclair Community Suite # 1000 Dumfries, VA 22025-1021 From INVOICE P.O. # Purchase Date Delivery Options Item Description Unit Price Quantity Tax Amount 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12 13. 14. 15. Shipping Charge State Sales Tax: Invoice Notes Subtotal - Discount + Tax Total Amount Paid Balance Due WE ACCEPT ALL MAJOR CREDIT CARDS & PERSONAL CHECKS MAKE CHECKS OR MONEY ORDERS PAYABLE TO "My Family Shops U.S.A." 4696 Fisherman's Cove, Suite # 1000, Dumfries, VA 22025 ALLOW 10 DAYS FOR PERSONAL CHECKS TO CLEAR FREE SHIPPING!**FREE SHIPPING!**FREE SHIPPING! DOMESTIC ORDER**PURCHASE ORDER OF $50.00 AND UP! INTERNATIONAL ORDER**PURCHASE ORDER OF $150.00 AND UP! Your Check Payment And Money Order Records : Your Contact Or Home Phone Number : Your eMail Address : Other Important Information :