Otto's Hungarian Import Store - Catalog Order Form

• PLEASE PRINT THIS FORM • COMPLETE WITH A PEN OR PENCIL • AND THEN FAX OR MAIL
Otto’s
European Import Store & Deli
2320 West Clark Avenue • Burbank, California 91506 • USA • Telephone: (818) 845-0433 • Fax: (818) 845-8656

DATE: ______________
| Ordered by:
| Address:
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| Country
| Telephone (Day): | Fax:
| E-Mail Address:
| Ship to: | Ship to:
| Address: | Address:
| |
| |
| Country | Country
| E-Mail: | E-Mail:
Include a separate order form for additional "Print Catalog" orders.

Number of	"Print Catalogs"	Ordered: ______ x $ 5.95 = _______
		T O T A L = _______

SHIPPING AND HANDLING INCLUDED!

• Feel Free to send a catalog to a friend or relative!

Checks, Money Orders, Visa, Mastercard, Discover, American Express, and Diners Club accepted.
Please make check or money order payable to: Otto’s Import Store & Deli

THANK YOU! - Köszönjük Szépen!

PLEASE COMPLETE THIS FORM FOR CREDIT CARD PURCHASES:
Otto’s
European Import Store & Deli
2320 West Clark Avenue • Burbank, California 91506 • (818) 845-0433 • Fax (818) 845-8656
Type of Card: Visa • Mastercard • American Express • Diners Club • Discover
Name of Cardholder: |
Card Number: _________| _________| _________| _________|
Security Code: (Listed on the "Back" or "Front" of the Card)
Usually 3 or 4 Digits
Expiration Date of Card: |
Amount: |
Cardholder's Billing Address: |
City / State (Province) / Zip Code: |
I agree to comply with Cardholder Agreement:
_____________________ ________ Date __________
Authorized Signature of Cardholder

- Thank you for your order! -

Köszönjük Szépen!

Otto's - Import Store & Deli
Since 1969

\| Ordered by:
\| Address:
\|
\|
\| Country
\| Telephone (Day):	\| Fax:
\| E-Mail Address:

\| Ship to:	\| Ship to:
\| Address:	\| Address:
\|	\|
\|	\|
\| Country	\| Country
\| E-Mail:	\| E-Mail:

Type of Card:	Visa • Mastercard • American Express • Diners Club • Discover
Name of Cardholder:	\|
Card Number:	_________\|	_________\|	_________\|	_________\|
Security Code: (Listed on the "Back" or "Front" of the Card) Usually 3 or 4 Digits
Expiration Date of Card:	\|
Amount:	\|
Cardholder's Billing Address:	\|
City / State (Province) / Zip Code:	\|