ORDER BLANK-for Ordering Just-Rite Pecans

To Print this Form Select FILE at the top of this page then select PRINT.
Mail to: Justice Nut Company, 500 S. Main St., Dermott, AR 71638 Fax to: 1-870-538-9324 E-mail: pecans@justicenut.com

Call for wholesale and custom packing quotes toll free at 1-800-282-2306.

ITEM #	DESCRIPTION	# of 5 lb. Bulk	TOTAL
1	Mammoth Halves	_____ x 30.00	_____
2	Native Halves	_____ x 27.50	_____
3	Large Pieces	_____ x 27.50	_____
4	Medium Pieces	_____ x 27.50	_____
5	Small Pieces	_____ x 27.50	_____
6	Midget Pieces	_____ x 22.50	_____

		Subtotal:					_____
		* Shipping & Handling to same Address:					+_____
		Arkansas Residents add 5.0 % Sales Tax:					+_____


	Total Amount Due:	$_____

Charge: [] Master Card [] Visa

Card Number: _______________________

Expiration Date: ______________________

V-code (3 digits on back of card): ________

Signature:___________________________

*Shipping & Handling to same address:

5 lb. case $ 9.50

two 5 lb. cases $10.80

Call our toll free number for shiping prices on larger quantities.

(PLEASE USE HOUSE NUMBER AND STREET ADDRESS)

Ordered by:	Mail to: (if different from person ordering)
Name____________________________	Name______________________________
Street____________________________	Street______________________________
City, State, Zip_____________________	City, State, Zip_______________________
Home/Work Phone__________________	Date to Ship_________________________
Signed___________________________	Greeting Card?_____(yes)________(no)
Date_____________________________	Sign Card:__________________________

Please attach names and addresses for additional ship outs or gifts.