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PAYMENT METHOD

Mastercard Visa American Express

Mustard Seed Gifts, Inc.
PMB #793, 12555 Biscayne Boulevard
North Miami, FL 33181-2522

Phone: (305) 681-7660
Fax: (305) 681-0554 (Credit card orders only)
E-mail:msgicharm@aol.com

Ordered by: Please Print Ship Gift To: Add $1.00
Name
______________________________________
Address
______________________________________
City, State, Zip 
______________________________________
Home Phone No._____________________
Work Phone No._____________________
e-mail address:_______________________
Name
____________________________________________
Address
____________________________________________
City                 State     Zip
____________________________________
Gift Card Message:__________________________

Item No. Description 14kt. Yellow Gold
Quantity
Unit Price Total
         
         
         
         
         
 Add $1.00 for Different Shipping address which includes a Gift Card with your message.      
Please mark method of payment: Total Merchandise Price  
 U.S.A.Check  USA Money Order
 Mastercard   Visa   Amer. Express
7% Sales Tax in Fla.  
Shipping & Handling  
Total  

X                                              Special Instruction________________________________________________
Authorizing Signature                            

Card Number
                               
CVV2 Number
       
Expiration Date
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