Order Form

Vern Potter Currency & Collectibles

Order Form (For FAX Orders Only)

Updated 10-09-18

ID No	Type No.	Specialty No.	Den	Description	Grade	Price
SC23456	Fr-2345	Hx-234-G213b	$4	*Example*	XF/AU	$ 100

Subtotal of Prices as Marked $________

Less Quantity Discount, as Applicable $________

9.50% CA Sales Tax, if Applicable $________

Postage & Insurance $________

GRAND TOTAL $________

Thank You Very Much for Your Order

To help expedite processing your order, please provide your name, address, telephone number and email address so we can confirm receipt of your order as soon as possible. Emails may be sent to Vern@VernPotter.com. Telephone orders may be placed at our office number, 310-326-0406. When we are out of town, our cell phone (310-994-3871) is on 24 hours a day, 7 days a week. Please see our Show Schedule for our travel plans.

If your email order is received while we are on the road, we will make every effort to respond to you, depending upon Internet facilities available at our location. When we are out of town our cell phone is always on and is a more positive method of communication. FAX, telephone and mail orders will be acknowledged upon our return.

Name_____________________________________________________

Address___________________________________________________

City, State__________________________ Zip Code_______________

Telephone (Day) _________________(Evening) __________________

Email Address _____________________________________________