Fax Order Form from Prestigetime.com, place your order via fax.

Fax Order Form: Please fill in, print and then fax to 845-357-8320

Item Description:

PDF version

Print Form

Manufacturer's Name:

Series:

Model Number:

Quantity:

Cost (as advertised):

Billing Information: (all information must be identical to that on your credit card)

Credit Card Type: (Visa, MC, Amex, Discover)
CID: (Visa, Mastercard, Discover: the last 3 digits printed on the reverse side of your card, usually on signature panel. American Express, the 4 digit number printed on face of card, above the last numbers of card.)

Credit Card Number:

CID Number:

Expiration Date:

Billing Name and Address:

First Name:

Last Name:

Address Line 1:

Address Line 2:

City:

State:

Zip Code:

Country:

Shipping Information

First Name:

Last Name:

Address Line 1:

Address Line 2:

City:

State:

Zip Code:

Country:

Email Address:

Contact Phone Number:

Best time to call:

Shipping Options:

FedEx Standard (3-4 days)	FREE	Continental USA deliveries only
FedEx Second Day Air	$20	Continental USA deliveries only
FedEx Next Day Air	$30	Continental USA deliveries only
FedEx Priority Next Day (before 10:30 AM)	$50	Continental USA deliveries only
FedEx Shipping	$50	Canada, PR or US Virgin Islands
FedEx International (orders up to $5,000)	$70	All countries except Canada
FedEx International (orders over $5,000)	$100	All countries except Canada

Cardholder Signature: ___________________________ Date: ____ / ____ / ____

We may require additional supporting documentation such as (1) A legible/clear copy of the front & back of your credit card. (2) A copy of a recent credit card or utility bill proving the "billing address". (3) A copy of photo ID, such as a Passport or Driver's License.