Bucio Lingerie Plus Size Lingerie Order Form

Ordering

Options

Credit Card:

Mail:

     Order On-line with our Secure Server
     CCNOW. Your credit card will not be
     charged until your order is shipped.
     Credit card orders must be billed to the
     name and address of the card holder.

       Print out the order form below
       and send with your check or
       money order to:

Bucio Lingerie
P.O. Box 811464
Chicago, Illinois 60681
USA

       Checks/Money Orders are
       deposited upon receipt.
       Returned checks are subject
       to a service charge for the
       maximum amount allowed by
       state law. Please add 8.75%
       for Illinois deliveries.

Phone:

Fax:

Call 1-888-211-4580 to use our
toll-free number.

Fax your order to 1-312-565-1750.

Order Form

P.O. Box 811464
Chicago, Illinois 60681
USA

Ordered By:

Name:_________________________________

Address:_______________________________

City, State, Zip:_________________________

Area Code,
Telephone:_____________________

Ship To: (if different)

Name:_________________________________

Address:_______________________________

City, State, Zip:_________________________

Area Code,
Telephone:_____________________

Style #

Qty.

Description of Item

Size

1st Color Choice

2nd Color Choice

Unit Price

Total

CREDIT CARD PAYMENT: (Please circle)

________________________|__________
Credit Card Number Exp. Date

__________________________________
Signature

Postage and Packaging

If Your Order Totals:

Up to $10.00	Add - $4.95
$10.01 - $25.00	Add - $6.50
$25.01 - $35.00	Add - $7.95
$35.01 - $50.00	Add - $8.95
$50.01 - $65.00	Add - $10.50
$65.01 - $75.00	Add - $11.95
$75.01 - $105.00	Add - $12.95
$105.01 - $150.00	Add - $14.95
Over $150.00	Add - $16.50

Merchandise Subtotal

Illinois Deliveries
Add 8.75% Sales Tax

Postage and Packaging
U.S. Customers Only

Total Amount Enclosed