| Mail to: M.J.'s Collectibles 8081 S. Madison Ave. Suite 289 Indianapolis,In.46227 |
(please print) Name:___________________________________ Phone #: ( ) - Address:________________________________________________ City, State, Postal code:_____________________________________________ Email Address:________________________________________________ |
| Quantity | Item | Cost (US$) | Total(US$) |
| ______ | ________________________________ | _________ | __________ |
| ______ | ________________________________ | _________ | __________ |
| ______ | ________________________________ | _________ | __________ |
| ______ | ________________________________ | _________ | __________ |
| ______ | ________________________________ | _________ | __________ |
| Sub Total (US$) | __________ | ||
| (Chart below)Shipping (US$) | __________ | ||
| Total (US$) | __________ |
| Credit card number | ____________________________________ | Exp__ | __ |
| Name on card | ____________________________________ | ||
| Are you authorized to use this card? Y__N__ |
| Card Holder Signature: ___________________________________________ |
| Shipping: | International - Customs, duties and any taxes are your responsibility |
| Canada - Customs, duties and any taxes are your responsibility | |
| US priority used when possible |
| Orders of | in US $ | US and Canada | International |
| up to $24.99 | $4.00 shipping | $8.00 shipping | |
| $25.00 - 49.99 | $7.00 shipping | $12.00 shipping | |
| $50.00 - 74.99 | $12.00 shipping | $20.00 shipping | |
| $75.00 - 99.99 | $15.00 shipping | $25.00 shipping | |
| $100.00 - 149.00 | $20.00 shipping | $30.00 shipping | |
| $150.00 & up | actual cost USPS | actual cost USPS |