Tori Tako Wind Designs					P.O. BOX 18183 SALT LAKE CITY, UT 84118
				801 964-8929  FAX 801 982-1410 ORDER LINE 888 232-6947
							Email: toritako@comcast.net
							Web: www.toritako.com
PLEASE PRINT
Opening order $250.00  shipped to one address. Back orders of less than $50 subject to cancellation.
First Order Credit Card. Terms N30 on approved accounts.
Company Name					Owner/Buyer:
Bill To Address					Ship To Address:
Phone #			FAX #:			Email:
PO#:		Order Date:	Ship Date:	Resale #:			Terms:
Credit Card #:						Exp. Date:			Pin #:
Credit Card Address:					Special Instructions:
Credit Card Authorization Signature:					Please Print Name:
QTY	ITEM #		DESCRIPTION					PRICE EA.	TOTAL
								TOTAL