KNAUB’S FARM ORDER FORM

1168 County Road 23 Narrowsburg, New York 12764

(845) 252-3781 sonny@knaubfarm.com

Please Print (Control + P) and Fill Out this Form. Mail with Payment.

Billing Information (Print Clearly)	Shipping Information (Print Clearly)
The name and address below would be those of the person placing the order.	You only have to fill this out if the billing address is a post office box, or if you want us to send your order to someone else.
First Name	First Name
Last Name	Last Name
Street Address	Street Address
Suite/Apt/Floor	Suite/Apt/Floor
City	City
State	State
Zip Code	Zip Code
Email Address	Email Address
Daytime Phone	Daytime Phone
Evening Phone	Evening Phone

Please make Check, Money Order, or Cashier’s Check payable to:

KNAUB’S FARM 1168 County Road 23 Narrowsburg, New York 12764

Quantity	Item Number	Page	Product Description	Unit Price	Total
Merchandise Total					$
Orders shipped to New York, Add 7.25% State Sales Tax					$
Shipping Charges					$
Total Amount					$

Shipping Charges: (On Merchandise Total Only)

$1.00	To	$25.00	For Office Use Only: Received Date: ______________________________ Processed Date: _____________________________ Shipped Date: _______________________________ Tracking Information: _________________________ Comments: _________________________________ ____________________________________________________________________________________ $5.95
$25.01	To	$35.00	$6.95
$35.01	To	$50.00	$7.95
$50.01	To	$75.00	$9.95
$75.01	To	$100.00	$11.95
$100.01	To	$150.00	$13.95
$150.01	To	$200.00	$15.95
$200.01	And	Over	$18.95