ZIGGYMART.COM ORDER FORM

PRINT THIS FORM ON YOUR COMPUTER PRINTER AND MAIL WITH PAYMENT TO:

ZIGGYMART HOME
ZIGGYMART ONLINE SHOPPING CART

DELIVERY INFORMATION

We ship all products by USPS Priority Mail OR UPS unless you specify faster or slower shipment.

U.S. SHIPPING & HANDLING


SOME INTERNATIONAL SHIPPING MUST BE CHARGED AS A SEPARATE CHARGE TO YOUR CREDIT CARD TO GET ACTUAL CHARGES AND MAY VARY FROM U.S. CHARGES LISTED ON SHOPPING CART. An example of a form

Please complete the following order form in full. You may use our Online Shopping Cart as a guide if you wish.

Your Details:
Name:
Address:
City:
State:
Country:
ZIP:
Daytime Phone #:
E-MAIL:
ITEM # AND/OR DESCRIPTION.........QUANTITY........PRICE _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________

PAYMENT METHOD:(CIRCLE ONE) VISA/MC/DISC/AMEX ACCOUNT#__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

SIGNATURE_______________________________EXP DATE_______

PLEASE MAKE ALL CHECKS OR MONEY ORDERS PAYABLE IN U.S. FUNDS TO: "ZIGGYMART" AND MAIL TO THE ABOVE ADDRESS.
BY SIGNING HERE:_______________________________________ UNDER THE PENALTY OF PERJURY, I TRUTHFULLY STATE THAT I AM AT LEAST 18 YEARS OLD/OR OF LEGAL AGE TO PURCHASE TOBACCO PRODUCTS (19 YRS OLD IN AK, AL, UT, or NJ) IN THE STATE IN WHICH I RESIDE. I HAVE ENCLOSED A CLEAR AND LEGIBLE SCANNED OR PHOTOCOPIED STATE DRIVERS LICENSE/PHOTO I.D. TO BE KEPT ON FILE BY ZIGGYMART FOR FUTURE ORDERS I MAY PLACE. REGULAR CUSTOMERS NEED NOT WORRY ABOUT THIS FORM OF IDENTIFICATION!

NOTE: PAYMENT BY MONEY ORDER (U.S. POSTAL M.O. PREFERRED) WILL RECEIVE TOP PRIORITY PROCESSING. PAYMENTS MADE BY PERSONAL CHECK OR BUSINESS CHECK WILL BE DELAYED 7-10 BUSINESS DAYS AND MUST CLEAR OUR BANK PRIOR TO SHIPMENT.