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Text File  |  1996-02-26  |  313b  |  25 lines
  1. Items:
  2.  
  3. Grand Total:             
  4.  
  5.                        __________
  6.  
  7. Sales Tax:               
  8.  
  9. Additional Shipping:     
  10.  
  11. Shipping:                
  12.  
  13. Items Total:             
  14.  
  15. Ship By:                 
  16.  
  17. Card Holders Name:       
  18.  
  19. Expiration Date:         
  20.  
  21. Card Number:             
  22.  
  23. Payment Method:          
  24.  
  25.