www.vistalatina.com
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www.vistalatina.com
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| Date:
__________________________________________
Sold To: |
Email:_________________________ |
| Name:
____________________________________
Address:________________________________________
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Form of Payment: _____ Check _____ Money Order _____ Visa/Mastercard #__________________ Exp. Date ________ Signature_____________________________ |
| ITEM # | DESCRIPTION | PRICE EA. | QUANTITY | TOTAL | ||
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SUBTOTAL: |
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TAX (AZ @ 8.1%): |
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SHIPPING & HANDLING: |
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