1616 S. Los Angeles Street, Los Angeles, CA  90015

TEL:  (213) 747-7777   FAX:  (213) 745-6046
 

 

READ THIS FIRST: RETURN POLICY

 

GAZOZ PURCHASE ORDER

 

 

BILL TO:

Name / Company

No. Street, Suite/Bldg. No.

City, State, Zip

  

SHIP TO:                               SAME AS BILL TO

Name / Company

No. Street, Suite/Bldg. No.

City, State, Zip
 

ORDER NO.:

*OPTIONAL

  SHIP VIA:

 

TERMS:

 

SHIPPING -

INSTRUCTIONS :

 

STYLE # COLOR

*OPTIONAL

QTY /

PIECES

 DESCRIPTION

*OPTIONAL

  PRICE / PIECE

  TOTAL

*OPTIONAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTES AND INSTRUCTIONS:

PLEASE READ THE RETURN POLICY   

 

 

FOR CREDIT CARD PAYMENT ONLY

CREDIT CARD AUTHORIZATION

This is to authorize Gazoz, Inc. to charge the amount stated below to my credit card.
Amount :

Credit Card Number :
Credit Card Name Holder :
Credit Card Billing Address :
Credit Card Expiration Date :

(CUV) Security Code :
 

BUYER'S INFORMATION: ( REQUIRED )
FULL NAME: 
E-MAIL:
PHONE. NO.:

FAX NO.:

 

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