Stanley Lisica
P.O. Box One New Baltimore MI 48047
USA
Fax: 586-716-7927 Email: orders@stanleylisica.com Internet: www.stanleylisica.com
Date: ____________
Name:______________________________________________ Account # ______
Address: ______________________________________________________________________
City: ________________________________________ State: _____ ZIP: __________
Payment is:
____Enclosed in the amount of $ _______
____Please charge the amount of $ ______to my credit card __Mastercard __Visa
Account # ____________________________________ Expiration Date: _________
Cardholder signature:
Postage:
U.S. Orders:
Shipped postpaid if over $20.00 otherwise add $1.00 on orders under $20.00. If insurance wanted on orders under $100.00, add $2.10.
International orders:
Shipped postpaid if over $40.00 otherwise add $2.00 on orders under $40.00. If registration wanted add $13.40 to all orders. No insurance available.
All stamps are mint, NH unless otherwise noted. STANLEY LISICA will not make any substitutions. Any item out of stock (o/s) will result in refund. No credit slips are issued unless prior agreement is made.
Qty | Country | Scott/SG # | Description | Price | Total | Office Use |
Postage, Insurance or Registration Charges (see above) | .................$ ________ |
Total |
.............. $ _____ |