NY Minute Enterprises / Everything NYC *PO BOX 2688 * Ronkonkoma, NY 11779 * FAX 212-208-0945
Please print this form and use it for Mailing or Faxing your order to us.
Bill To: (name and address)  Ship To:(if different from Bill To) 
Name: ________________________________ Name: ________________________________
Address: _______________________________ Address: _______________________________ 
Address: _______________________________ Address: _______________________________
City:_______________ State:___ Zip:________  City:________________ State:___ Zip:________ 
Telephone:______________________________ Telephone:______________________________
Email:_________________________________  

List of Items:
 
Item #: Item Name:  Quantity: Unit Price: Merchandise Total:
_______ _________________________ ______ ___________ _________
_______ __________________________ ______ ___________ _________
_______ _________________________ ______ ___________ _________
_______ _________________________ ______ ___________ _________
_______ _________________________ ______ ___________ _________
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Please Note: If paying by credit card, your card will be billed by "NY Minute Enterprises"
Money Orders must be in U.S. funds only. Foreign checks will not be accepted.



Merchandise Total:   Priority Mail Shipping:  
up to $15.00   add $4.00                                                                      Merchandise Total:________
$15.01-$50.00   add $5.00  
$50.01-$75.00   add $6.00                                                  Priority Mail Shipping (see chart):________
$75.01-$100.00   add $8.00                                                  NYS Residents must add 8.5% Tax :________
$100.00-$199.99   add $10.00 . 
$200.00-UP   add $12.00
Foreign Orders   add $16.95
 
                                                                                           TOTAL:_______

Method of Payment:
___Check or money order (payable to "NY Minute Enterprises")
___ American Express ___ Mastercard ___ Visa

Credit card #____________________________ Expiration Date:____________

Signature____________________________

How did you hear about our website?_______________________________________________________________________________________

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