Name
Street Address
Street Address2
City/State/Zip
Daytime Phone
Email

Payment Method

Check/M.O.

Visa

Mastercard

Cardholder

Card #

-

-

-

Exp. Date

-

Signature

Ship to (if different from above):

Name
Address
Address2
City/State/Zip

Item #	Description	Qty.	Unit Price	Total
Continental US Shipping & Handling is as follows: Order Amount Shipping & Handling fee Under $100.00 $6.95 $100.00 to $199.99 $9.95 $200.00 to $449.99 $19.95 $450 and up $49.95 Please make checks payable to: Nexus Imports, LLC. FAX to (703)997-2294 -OR- mail to: Nexus Imports, LLC 7307 Arlington Blvd. #156 Falls Church, VA 22042 Questions? Email us at info@nexusimports.com for a prompt reply or call Matt Brown at 703.863.8598. You can also check our FAQ.
		Subtotal
		VA Residents add 4.5% sales tax
		S & H
		Total