LIGHT BULB ENERGY HOTWIRE ORDER FORM

To order, PLEASE PRINT OUT THIS PAGE, [make sure all four (4) columns below fit within your window before printing; widen your page if necessary] complete all information below and mail the
completed form with your payment or payment information to:

B and B Ventures, Inc. ATTN.: BULB HOTWIRE
PO Box 8102; Hicksville, NY 11802

Please make checks payable to: B and B Ventures, Inc.

PLEASE NOTE: THESE BULBS ARE FOR THE UNITED STATES MARKET ONLY!
ORDERS FROM COUNTRIES WITH DIFFERENT ELECTRICAL VOLTAGE CAN NOT BE ACCEPTED. FOR MORE INFORMATION CALL OUR HOT LINE NUMBER.

 Order Code

 Quantity

 Price Each

 Total
       
       
       
       
       
       

 ORDER TOTAL:  
 Only a HANDLING fee of $6.95 has to be added here:
  
 NEW YORK STATE RESIDENTS ADD SALES TAX:
County Name ________ Percent Sales Tax _____%
  
 GRAND TOTAL:  


SHIP TO ADDRESS: No post office boxes please.
Name:
Attention:
Address:
City:
State: Zip Code:
Internet E-Mail Address:(kept confidential)
Telephone Number with area code:(kept confidential)
METHOD OF PAYMENT - Please check one:
American Express Check Money Order
Please fill out all information below when using a Charge Card:
Charge Card #:
Expiration Date:
Name as printed on Credit Card:
Address Credit Card Billing goes to:
Town: State:
Zip Code: YOUR SIGNATURE as on Card: _________________________

An order form will be returned to you with your order. Please allow 10 to 15 working days for delivery. All orders are shipped UPS. Thank you for your order. If you have any questions, please call our Light Bulb Hot Line.

Return to see the different energy and money saving light bulbs.