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1269FAX ORDER FORMDate: Account # Ordered by: Account Name: Address: City/State/Zip: PO #: Phone #: Fax #: Ordered by: PLEASE CHECK ONE IN EACH CATEGORY:U.S. SHIPPING: SHIPPING OPTIONS: UPS: (Please refer to section on Company Policies) %u2022 Ground_____ Ship as Available_____ %u2022 2-Day_____ Ship in Two Shipments_____ %u2022 Next Day & Call as Available_____ Next Day Air_____ Ship w/next Shipment_____ %u2022 Saturday Delivery_____ Ship Complete_____ (For orders shipping Friday Only) US MAIL: %u2022 Priority_____ %u2022 1st Class_____QTY STYLE# LENGTH/SIZE DESCRIPTION PG# (S)ET/(B)LANKB/O(Y)ES, (N)O SUBSQUALITY GOLD, INC. | FAX (800) 686%uf6ba7184 | PHONE (800) 354%uf6ba9833CANADA SHIPPING: POST: %u2022 Expedited_____ %u2022 Express Post_____ %u2022 Priority_____ UPS: %u2022 Worldwide Saver_____ COMMENTS:___________________________________________________________ _____________________________________________________________________________________________________________________________________