Pfaelzer Brothers Holiday Catalog 2016 Page 14 Pfaelzer Brothers

Order Form Ordered By Order toll-free 800.621.0226 Order online pfaelzerbrothers.com Fax your order* 888.904.5327 Mail your order Catalog Order Center, Dept. P 811 Madison Ave., 5th Floor Toledo, OH 43604-5616 Customer Service 800.621.0202 Weekdays 8:30 am - 8:00 pm EST *Fax orders: We will acknowledge your fax order within 48 hours. To avoid duplicate orders, which will be billed to your account, please do not refax or mail your fax order. If you experience transmission problems, please call 800.864.4158. CUSTOMER NUMBER CODE NUMBER Name___________________________________________________________________________ Address_________________________________________________________________________ City/State/Zip_____________________________________________________________________ Daytime Phone (required)_______________________________________________________ ____ Order confirmation and shipping notification is provided by email only. Please provide an email address if you would like to receive these communications. You will also be notified of new product news and special offers by email newsletter. My Email Address_________________________________________________________________ Your email address will not be provided to any other company outside the Pfaelzer Brothers family of brands. Method Of Payment Check Make check payable to Pfaelzer Brothers. Visa Mastercard Discover American Express Credit Card Number Card Expires Signature ___________________________________________________________ _____ Please Ship These Pfaelzer Brothers Items To My Address Item # Qty Page # Price Each Total Price Merchandise Total $ State Sales Tax Total $ Delivery Charge (Merch Total Only) $ Total #1 (Transfer to box below) $ _________ Select your Standard Delivery option (check one box only): Ship Now Delivery in 3-7 business days from order date. Delivery By Date _____/_____/_____ Indicate your delivery by date (at least 7 business days or more from date order is placed), and your gifts will ship to arrive on or before that date. Thanksgiving Delivery Christmas Delivery (12/12- 12/23/2016) (See Chart On Opposite Page) Please Ship These Pfaelzer Brothers Gifts To The Name Listed Below Name _______________________________________________ Address _____________________________________________ City/State/Zip _________________________________________ Daytime Phone (required) _________________________________ From & Gift Message ____________________________________ ___________________________________________________ Item # Qty Page # Price Each Total Price Merchandise Total $ State Sales Tax Total $ Delivery Charge (Merch Total Only) $ Total #2 (Transfer to box below) $ _________ Select your Standard Delivery option (check one box only): Ship Now Delivery in 3-7 business days from order date. Delivery By Date _____/_____/_____ Indicate your delivery by date (at least 7 business days or more from date order is placed), and your gifts will ship to arrive on or before that date. Thanksgiving Delivery Christmas Delivery (12/12- 12/23/2016) (See Chart On Opposite Page) Name _______________________________________________ Address _____________________________________________ City/State/Zip _________________________________________ Daytime Phone (required) _________________________________ From & Gift Message ____________________________________ ___________________________________________________ Item # Qty Page # Price Each Total Price Merchandise Total $ State Sales Tax Total $ Delivery Charge (Merch Total Only) $ Total #3 (Transfer to box below) $ _________ Select your Standard Delivery option (check one box only): Ship Now Delivery in 3-7 business days from order date. Delivery By Date _____/_____/_____ Indicate your delivery by date (at least 7 business days or more from date order is placed), and your gifts will ship to arrive on or before that date. Thanksgiving Delivery Christmas Delivery (12/12- 12/23/2016) (See Chart On Opposite Page) Thank you for shopping with us! TOTAL #1 $ _________ TOTAL #2 $ _________ TOTAL #3 $ _________ GRAND TOTAL $_________ 800.621.0226 1 4

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