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Order Form
Brandon Bait and Tackle Accept Visa, MC and Discover
Phone 405 359-3886 Checks & Money Orders Date:________________
Fax 405 605-2697
Name_______________________________________
Street Address_______________________________
City, ST, Zip__________________________________
Phone______________________________________
Qty Item# Description Unit Price Total
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Shipping Standard Delivery Discount _________
Merchandise Total Price Sub Total _________
$0.01- $15.00 $4.00 Sales Tax (OK) _________
$15.01-$40.00 $5.50 Shipping _________
$40.01-$75.00 $7.50 Total _________
$75.01-$100.00 $9.50
$100.01-up $12.50
Please Check Type of Payment _____Personal Check or Money Order Payable To Brandon’s Bait & Tackle
___________Visa_______________Master Card____________Discover
Name_____________________________Card Number_____________________
Expiration Date______________3# code on back of card___________
Signature__________________________________________
Thank you for your Business!
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