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ORDER FORM

Qty Item or model Description, & color if applicable Price Qty total

                                                                                                                                         Sub-Total:
Percent of sub-total to add for shipping & handling: Upto $50 -- add 22%
                                                                              $51 - $100 -- add 15%
(Rates for Common Carrier,                                   $101 - $200 -- add 12%
LTL shipping are calculated separately.)                 $201 - $400 -- add 10%
                                                                             $401 and over -- add 9%     Shipping & handling:
                                                                                                                                        Sub-Total:
                                                                                          NY residents, please add 8Ľ% sales tax:
                                                                                                                                  Grand Total:
                                Required shipping information
Ship-to name:
additional line:
Street address:
additional line:
City: State: Zip:
H. Phone: W. Phone:
Email Add:
      Please fill in if paying by Credit Card
VISA or MC (Please check one)                     OR Fax (607) 729-4761 or mail this order payable to:
Card #:    Spectrum Products
Expiration Date: CVV2 (3 digits):    757 Pollard Hill Rd
Card Holder Name as it appears on the card:               Johnson City NY 13790-4218
     Note: This credit card transaction is insecure.
Card Holder Signature: (if mailing in)