Mail In Order Form

The Jax Cat Tackle Company
Mail in Order Form
To order via USPS Mail simply print this form, fill it in, send payment (Check/Money Order/Credit Card Info) and receive your items. If paying by check or money order please allow time for the check to clear. Thank you!
Please send this form with payment to: Jax Cat Tackle Company, PO Box 383, Becket MA 01223.
All Checks should be made out to: The Jax Cat Tackle Company
What would you like to order today? Please write down model and item number. Where applicable, please include size.
Select Model Number/ID
Quantity/Cost per item
Ex: Storm Hot n Tot
HM 561 Firetiger Flash
4 @ $4.89 each

Shipping Charges *

Mass Sales Tax 6.25% **

*Please add Shipping Charges: Click Here to see Shipping Charts. Items will not ship without the appropriate charges.
**Mass sales tax: If shipping to a Mass location we must charge Mass sales tax: Please add 6.25% to your order.
Method of Payment: Please circle one: Credit Card (fill in Credit Info), Personal Check, Money Order, E-mail me a Pay Pal Invoice or Google check out Invoice (Must have a Pay Pal or Google Check Out account and provide an e-mail address)

Your Shipping info:
Name: _________________________
E-mail Address___________________
Phone Number: __________________
Street: _________________________
PO Box: _______________________
City: __________________________
State: _________________________
Zip: __________________________
Credit Card Information: (Only if paying by Credit Card)
Name as it appears on card: ___________________
Card Number:______________________________
CVV#: ___________________________________
Expiration Date:_____________________________
Please read the following: I authorize Jax Cat Tackle
to charge my credit card number above, in the amount of: 
(place total of order + shipping + sales tax here)

Confirmation Signature: ________________________

Thank You!