Deerely Departed
by: JD Heritage
South Pacific
JD HeritageŽ
Deerely Departed
11115 Knoxville Rd.
Milan, IL. 61264
USA
Order online!
DeerelyDeparted.com
International
Call: 1-309-787-1432
Available For Credit Card Orders
 OUTSIDE CONTINENTAL US
  International orders CALL: 1-309-787-1432
 First Name Last Name
 Street Number Street Name
 City/County  
 (Complete only when you wish the merchandise to ship to another address.)
 First Name Last Name
 Street Number Street Name
 City/County  
 TELEPHONE / FAX / E-MAIL   (Order will not be shipped if a telephone number is not provided.)  
Daytime Phone (       )_________________________
Evening Phone (        )_________________________
 E-mail Address _________________________
Fax _____________________________
Page Item Color
Code		 Size
Code		 Qty. Description Price Ea. Total
                   
                   
                   
                   
                   
                   
                   
                   
   
 Do you wish a backorder? ___ Yes ___ No

 METHOD OF PAYMENT (No Cash or Stamps)
 INT'L Postal/Bank Money Order
 Visa®  (13-16 num)    American Express® (15 num)
 Mastercard® (16 num) 
Please include the numbers on the metallic portion of the card.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

  X__________________________
MO        YR
Expiration Date Required         CARDHOLDER'S SIGNATURE
JD HeritageŽ makes every effort to give you the lowest price.
Merchandise prices and specifications may be subject to change without notice.

ERRORS: Descriptive, typographic, or photographic errors are subject to correction.
   Total of All Merchandise

    Delivery Charges
 Use line #11 and Shipping Chart
to apply delivery charge
Check one: Air Surface
   TOTAL  
Shipping Chart
Merchandise Total Air Charges Surface Charges
$0.00-$50.00 $25.00 $15.00
$50.01-$100.00 $35.00 $20.00
$100.01-$300.00 $45.00 $25.00
$300.01-$300.00 $50.00 $35.00
$300.01 and up $60.00 $40.00