ORDER FORM

ORDER FORM:
Please note: No orders are considered final until the factory agrees, you accept the shipping charge and
the order is paid for in full. Please consult How Do I Pay for more information.

Date Ordered________________________

Date Wanted By:_____________________

Sofa and Mattress Outlet
606 E. State St
Athens, OH 45701
740-593-5000

Sold To:_______________________________________

Contact Name__________________________________

Office Phone______________Cell__________________

Office Fax Number (if available)_____________________

Ship To:______________________________________

_____________________________________________

_____________________________________________

Please print out this form, write in your order and fax it to 740- 594-1333

If a furniture style (sleeper, ottoman etc.) is not on the pricelist with the photo
of the group from which you are ordering then it is not available.

Add up the total number os seats of your order and do not exceed 168 seats.