INFORMATION: No COD's to retail customers. Orders are shipped to the credit card billing address. You can mail to the address below.

E-MAIL * (Important for all orders - be sure to type correctly):

NAME * (Your full name - as it appears on your credit card):

ADDRESS * (billing address of your credit card):

CITY, STATE and ZIP *

Day/Eve/Fax PHONES *(Please label each)

Ship to if different: (Not for credit card orders! Include C/O if applicable)


PLEASE SEND ME THE FOLLOWING ITEMS:
Write over any defaults as desired.

Please include [QUANTITY (otherwise 1 is assumed), SIZE, ITEM #, DESCRIPTION, COLOR and PRICE].
1.
2.
3.
4.
5.
6.
7.
8.


SUBTOTAL

S/H for Orders less than $150.00
8% SALES TAX for: COUNTY.
TOTAL PAYMENT

PAYMENT:
VISA/MASTERCARD AMERICAN EXPRESS DISCOVER JCB
Credit Card Number: * Exp. Date: *
CID# *: (REQUIRED - VISA, MC, DISCOVER: 3 digits located on back of card, AMEX: 4 digits on front above card number)

__ PAYPAL (To send money through PayPal click on Paypal logo. Our Paypal e-mail address is : info@dynamicleather.com                               
                                                                         
__ PERSONAL CHECK (Print this form and mail to the address below - We must hold order for 20 days)
__ MONEY ORDER (Print this form and mail to the address below - with no delay)
__ WESTERN UNION Visit WESTERN UNION website and locate your closest agent. Complete the "To Send Money" form. Give the agent the amount you require plus the transaction fee (estimated $15 to $50 depending on country and amount). Save your receipt with your Money Transfer Control Number (MTCN) and enter to form below and any password required for pickup.

Messages or Special Instructions: Western Union Control number, comments, messages and/or measurements as needed: (measurements will not guarantee perfect fit but may help our expert packers)
IMPORTANT: Credit card orders can only be shipped to credit card billing address noted above.

You may also send this form to:
DYNAMIC LEATHER
6391 Avery Street SW Covington, GA 30014
Phone # 404 729 3965
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