BRENT JESSEE RECORDING & SUPPLY, INC. USA ORDER FORM
                   (Print a copy of this order form for FAX or mail-in orders)
                                     FAX: 847-963-1561 



NAME______________________________________________________

ADDRESS___________________________________________________

CITY_____________________________STATE______ZIP___________

PHONE____________________________E-MAIL___________________

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PART #___________DESCRIPTION_______________________QTY___PRICE____TOTAL_____

PART #___________DESCRIPTION_______________________QTY___PRICE____TOTAL_____

PART #___________DESCRIPTION_______________________QTY___PRICE____TOTAL_____

PART #___________DESCRIPTION_______________________QTY___PRICE____TOTAL_____

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ILLINOIS RESIDENTS ONLY: Add 10% tax to your order

SUBTOTAL____________________

TAX__________________________

SHIPPING_____________________

TOTAL_______________________
USPS Priority Mail $8.00 up to 2 lbs.  UPS Ground $11.00 up to 2 lbs. with insurance
for up to $100 in merchandise included, for additional coverage add
$2 per $100 in merchandise.  Priority Mail insurance (if desired) is optional.
add $1.00 up to $50 value, $2.00 up to $100 value, $5.00 from $100 up to $200
value, and additional $2 per $100 merchandise above $200 value.  

Personal check, cashier's check, money order, business check or traveller's cheques accepted.
We also accept Master Card, Visa, American Express, or Discover credit
cards.  Please indicate name on card, card number, expiration date,
and the three digit number on the back of the card.

CREDIT CARD ORDERS ONLY:

CARD TYPE_______________________  CARD NUMBER________________________________

EXPIRATION DATE_________________  3-DIGIT CODE (on back of card)_____________

PRINT A COPY OF THIS ORDER FORM, FILL IT IN, AND MAIL WITH YOUR PAYMENT TO:
BRENT JESSEE RECORDING
1566 W. ALGONQUIN RD. #111
HOFFMAN ESTATES, IL  60192

FAX ORDERS: Please print out this form, fill out in dark ink including your
credit card information, and fax to 847-963-1561, 24 hrs. a day, any day.

Tubes are tested just prior to shipping and are guaranteed to be operational.
Defective tubes must be returned within 30 days for replacement or refund
of sales price.  This guarantee does not cover tubes damaged by breakage or
by operation outside of manufacturer's specifications.