FireworksRus Faxable Order Form


	International Fireworks Mfg. Co. P.O. Box 6, Sycamore Road Douglassville, PA 19518


Phone 610-385-3086

	Payment Details:

		(Check Box)


	Toll Free 1-888-811-BOOM

	MasterCard
	Visa
	Money Order
	Certified Check
NO CHECKS OR C.O.D.’S


	Sold To:

	Ship To:

Name:	_________________________________________
Address:	_________________________________________
City:	__________________	State: ____	Zip: _______

Name:	_________________________________________
Address:	_________________________________________
City:	__________________	State: ____	Zip: _______

Card Number:	_____________________________
Expiration Date:	______________
Signature:	_____________________________

We cannot ship your order without a phone number
Home Phone:	(___) ___________________
Home Phone:	(___) ___________________

I, ________________________________________, hereby state as a condition of this purchase that I have and comply with the laws of the state of destination of the merchandise offered for sale in this catalog. I will also agree I will obtain any necessary permits required by law and will use or sell this catalog’s merchandise in strict compliance with all Federal, State, County, City, and Municipal laws. International Fireworks Mfg. Co. will not be responsible for any losss of product due to legal violations once it leaves our warehouse. We will not sell fireworks to anyone under age of 18 years. International Fireworks Mfg. Co. will not assume any liability for any legal action during the transportation, handling, storage, use or sale of these fireworks. I also understand that fireworks are dangerous, I will assume all risks regarding them.

Signature: _____________________________

We will not ship your order without a signature

Item#	Quantity	Description	Price	Total

Office Use Only
Date In:	___________________
Date Pulled:	___________________
Date Shipped:	___________________
Checked By:	___________________


	Fax your order to 610-385-3754

Total First Page:
Total From Last Page
Sub Total
Shipping & Handling

Total


	Page 2 for faxed order if needed:


	Fax your order to 610-385-3754


	International Fireworks Mfg. Co. P.O. Box 6, Sycamore Road Douglassville, PA 19518


	Sold To:

Name:	_________________________________________
Address:	_________________________________________
City:	__________________	State: ____	Zip: _______


	Toll Free 1-888-811-BOOM

		Ship To:

Phone 610-385-3086

Name:	_________________________________________
Address:	_________________________________________
City:	__________________	State: ____	Zip: _______

Item#	Quantity	Description	Price	Total

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FireworksRus, P.O. Box 6, Douglassville, PA 19518.
Ph: 888-811-BOOM Email Us: sales@fireworksrus.com