4239 67th Ave. Circle E.
Sarasota, FL 34243

Phone: 941-756-6999
Fax: 941-756-6999

Email: newfarm@fbconnect.net

Ship to Name: Date:

Address:

City/State: Zip:

Phone: Area code( )

ITEM DESCRIPTION	QTY	UNIT PRICE	AMOUNT








SUBTOTAL
SHIPPING & HANDLING/ ADD 10% OF TOTAL ORDER (MINIMUM $9 SHIPPING & HANDLING PER ORDER) Orders Will Be Delayed If Proper Shipping & Handling Is Not Included FLORIDA RESIDENTS ADD 7% SALES TAX

TOTAL ENCLOSED (U.S. FUNDS ONLY)

Check enclosed (Make it payable to New Farm)

Please charge to my:
MASTERCARD
VISA

Account #: Expiration Date:

Signature: