Print this form to fill
out and mail with your payment to:
Pan Pacific Imports, 3080 West Prentice Ave., Littleton, CO 80123 or FAX to
us at 303-794-1125.
Name
Company
Name
Address
City
State
Zip
Code
Telephone
Fax
E-Mail
SHIP
TO
Same
Address as Above
Name
Company
Name
Address
City
State
Zip
Code
In the space
below, please provide the Item Name with the corresponding Catalog
Number.
Item
Name(s) and Catalog Number(s) ... please print clearly.
PAYMENT
BY Visa, Master Card, COD, or prepayments with a business check
are accepted methods of payment at Pan Pacific Imports.
