Inside Mexico

 Fax Order Form

Thank you for your order. PLEASE PRINT THIS PAGE OUT and fill in your information.
Sign the signature blank, AND FAX TO: 1 (281) 362 8557

If you have any questions about your order, or wish to check
its status, please email us at: may@mataortiz.com

Customer Credit Card Information

Name on Card:
Card Type: (We accept VISA, Mastercard, AMEX, Discover)
Card Number:
Expiration Date (mm/yy)
CVV2 Code: 
In signature strip on back of card, to the right of the card number, is the 3 digit CVV2. Enter 000 if missing/illegible.
Your Address:
 
Your e-mail:
Your Phone:

Signature:___________________________________ (Required)
 

Fill in shipping information if different from above.
Name:
Address:
Address:

Order Summary
Click on the buy button of the item (s)  you are purchasing. When finished click "View Cart" to fill the information required bellow.

Item Ordered:   $
Item Ordered:   $
Item Ordered:   $
Item Ordered:   $
Item Ordered:   $
If in Texas add 6.25% Sales Tax   $
Shipping Cost:   $
GRAND TOTAL   $

Special Instructions

 
 


End of Order