Shipping Name & Address (If different than Billing Address above): ___________

_______________________________________________________________

_______________________________________________________________

PAYMENT METHODS (Choose one of the three options):
1) Name on Credit Card: ____________________________________________

Credit Card Type (circle one):     MasterCard    Visa    Discover    American Express

Credit Card Number: _______________________________________________

Expiration Date: __________________ Credit card verification number*: _______

2) Check #: _______________________   

3) Money Order #: __________________

PRODUCT ORDER (Attach another sheet if necessary):
Product Code _________________
Product Price $_______________    x  Quantity _______  =  Amount $__________

Product Code _________________
Product Price $_______________    x  Quantity _______  =  Amount $__________

Product Code _________________
Product Price $_______________    x  Quantity _______  =  Amount $__________

Product Code _________________
Product Price $_______________    x  Quantity _______  =  Amount $__________

Product Code _________________
Product Price $_______________    x  Quantity _______  =  Amount $__________

Product Code _________________
Product Price $_______________    x  Quantity _______  =  Amount $__________


Shipping Cost: _______________________________________________________
USA Shipments: Enter preferred method of shipment
(UPS Ground, UPS Next Day Air, UPS 2nd Day Air, UPS 3 Day Select, USPS Priority Mail).
International Shipments:  Enter preferred method of shipment (USPS Global Express Mail).

Shipping charges are actual shipping costs based on weight and destination. Please expect Next-Day
Air, 2nd Day Air, and 3-Day Select to ship on the next business day (M-F) following your order or
when your check clears. Add your order to the shopping cart to estimate shipping costs by using the
"Shipping Estimator" on the first page of the shopping cart. No personal information is required to see
the shipping calculation. Or, email the shipping address and order contents to orders@waterfilters.net
for a shipping calculation to be emailed to you.


Subtotal: __________________________________________________________

Sales Tax (6.5% MN only): ____________________________________________

Total Amount: _____________________________________________________

THIS TRANSMISSION CONTAINS CONFIDENTIAL INFORMATION INTENDED FOR USE
ONLY BY THE ABOVE MENTIONED RECIPIENT. READING, DISCUSSION, OR COPYING OF
THIS MESSAGE IS STRICTLY PROHIBITED BY ANYONE OTHER THAN THE NAMED
RECIPIENT, OR HIS OR HER EMPLOYEES OR AGENTS. IF YOU HAVE RECEIVED THIS
DOCUMENT IN ERROR, PLEASE NOTIFY US BY TELEPHONE (COLLECT), AND RETURN
TO US AT THE ABOVE ADDRESS VIA THE U.S. POSTAL SERVICE.

*What is a Credit Card Verification Number?
Credit card verification numbers enable an important security feature
for credit card transactions on the Internet and over the phone. A credit
card verification number (CVV2) is the three- or four-digit number printed
in the signature space on the back of most credit cards and on the front of
American Express cards, like this:





Some newer credit cards only show the last four digits of the credit card
number on the back, followed by the CVV2 number.

The CVV2 number enhances fraud protection and helps to validate two things:

• The customer has the credit card in their possession.
• The credit card number is legitimate.