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Text File  |  1995-01-13  |  3KB  |  48 lines
  1. Caviarteria                                 Ship To:                         
  2. 158 S. Beverly Dr.     29 East 60th St.      -------------------------------
  3. Beverly Hills, Ca      New York, NY         |                               |
  4. 90212                  10022                |                               |
  5. USA                    USA                  |                               |
  6.                                             |                               |
  7. 1-800-287-9773         1-800-4-CAVIAR        -------------------------------
  8.                                             Ship Via :
  9.                                                        ---------------------                     
  10.  ---------------------------------------------------------------------------
  11. | Page |       Item Description      |  Size  | Quant |  Price  |   Total   |
  12. |------|-----------------------------|--------|-------|---------|-----------|
  13. |      |                             |        |       |         |           |
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  15. |      |                             |        |       |         |           |
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  17. |      |                             |        |       |         |           |
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  19. |      |                             |        |       |         |           |
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  23. |      |                             |        |       |         |           |
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  25. |      |                             |        |       |         |           |
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  27. |      |                             |        |       |         |           |
  28.  ---------------------------------------------------------------|-----------|
  29.                                                Total Merchandise|           |
  30.                   ---------------                               |-----------|
  31. Credit Card Type |               |                      Shipping|      $5.00|
  32.                  |--------------------------------------        |-----------|
  33.      Card Number |        :         :         :         |  Total|           |
  34.                  |--------------------------------------|        ----------- 
  35.      Expiry Date |        /         |                   |
  36.                  |--------------------------------------|
  37.        Signature |                                      |
  38.                   -------------------------------------- 
  39.                  
  40.                  SOLD TO : (Statement Address only, see top 
  41.                             of page for Shipping)
  42.                  ------------------------------------------ 
  43.                 |                                          | 
  44.                 |                                          | 
  45.                 |                                          | 
  46.                 |                                          |
  47.                  ------------------------------------------ 
  48.