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GTF MAIL ORDER FORM To order by mail, print this form and mail it with your money order to the address below. 1. List the items you wish to order: ITEM 1 ____________________________________________________________________________________ PRICE ________________ITEM 2 ____ ________________________________________________________________________________ PRICE ________________ITEM 3 ________ ____________________________________________________________________________ PRICE ________________ITEM 4 _________ ___________________________________________________________________________ PRICE ________________ITEM 5 ____________________________ ________________________________________________________ PRICE ________________ITEM 6 ________________________________ ____________________________________________________ PRICE ________________ITEM 7 _________________________________ ___________________________________________________ PRICE ________________ITEM 8 _________________________________ ___________________________________________________ PRICE ________________ITEM 9 ______________________________________ ______________________________________________ PRICE ________________SUB-TOTAL $ ________________In California? Add 8.75% sales tax $ ________________ In the United States , Canada, or Mexico? Add $3.00 for shipping $ ________________Not in the U.S., Canada, or Mexico? Add $5.00 for shipping $ ________________TOTAL AMOUNT OF ORDER $ ________________
2. What is your shipping address? NAME ______________________________________________________________________________ _____________________________ADDRESS ___________________________________________________________________________ _________________________________________________________________________________________________________________ _____________________________CITY _______________________________________________________________________________ _____________________________STATE OR PROVINCE __________________________________________________________________ _____________________________ZIP CODE OR POSTAL CODE ______________________________________________________________ ___________________________COUNTRY ____________________________________________________________________________ ____________________________
3. Read the following declaration and sign below: I hereby swear or affirm, under penalty of perjury, that: I am currently an adult, at least 18 years of age;I am voluntarily purchasing these materials because I want to view such materials for my own personal enjoyment and/or education; I believe that a desire to view sexually explicit materials for enjoyment and/or education is a natural, healthy, and normal part of human behavior; I understand that the materials I am seeking to acquire are sexually explicit, I am not offended by such materials, it is legal for persons of my age to purchase sexually explicit materials, such as those I seek to purchase, in my community and I will not order, or in any way acquire, materials or goods that would be unlawful to view or possess in my community; I am familiar with the standards of my community pertaining to the distribution and/or viewing of such materials and the materials I am ordering will not offend the contemporary standards in my community and will not be found by an average member of my community to appeal to a prurient (unhealthy) interest in sex and/or to be patently offensive;I will not show or distribute the materials to any individual who has not reached the lawful age to view such materials, or who might be offended by such materials; I am not ordering these materials to use them against any interests of any person or entity; I will indemnify and hold harmless the provider of these materials from any and all civil claims or criminal charges that result from my ordering and/or distributing, in any manner, the materials. I declare under penalty of perjury that the foregoing is true and correct.
YOUR SIGNATURE _________________________________________________________________________________________________ PRINT YOUR NAME _________________________________________________________________________________________________ TODAY'S DATE ____________________________________________________________________________________________________
4. Make your money order payable to "SINGULAR CONCEPTS" and mail it with this form to: SINGULAR CONCEPTS
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