BREAKAHEART RANCH

Please provide the following contact/shipping/payment information (we accept MasterCard/Visa):

Name		Country
Street Address		Home Phone
Address (cont.)		E-mail
City		Credit Card
State/Province		3 digit Security Code
Zip/Postal Code		Exp. Date

Please provide the following ordering information:

QTY	STOCK #  -  DESCRIPTION	PRICE	EXTENSION
		SUB TOTAL
	Texas residents please add 7.25% sales tax	7.25%
		SHIPPING SEE CHART
		GRAND TOTAL
	The following shipping charges apply within the continental United States.
$ ORDER TOTAL SHIPPING CHARGES 00.00 - 19.99 9.95 20.00 - 29.99 10.95 30.00 - 39.99 11.95 40.00 - 49.99 13.95 50.00 - 59.99 15.95 60.00 - 74.99 18.95 75.00 - 89.99 22.95 90.00 - 104.99 25.95 105.00 - 149.99 28.95 150+ 31.95

Fax your order to us with your credit card information at 830/438-3139,

or mail it to us with your check or credit card information.  We accept MasterCard or VISA.

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