AMSTERDAM FILMS, INC
D/B/A/ CARTER STEVENS PRESENTS
ORDER FORM

(Print and fill out completely)

SHIP THIS ORDER TO:
Name _______________________________________________________________________  

Address ____________________________________________________________________

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City __________________________________ State __________________ Zip ___________

Phone _____________________ FAX ______________________ Email __________________ QTY. STOCK # DESCRIPTION EACH TOTAL

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___|_________|___________________________________________|________|_________ SHIPPING & HANDLING Newspapers & Magazines will be charged $4.95 PER ORDER Videos will be charged $5.95 EACH for Subtotal |_________ first item and $2.50 each additional item. Shipping/Handling |_________ Shipping out of the United States add $10 US Overseas|_________ SHIPPING FOR DVDs IS A FLAT $5.00 FOR FIRST 3 DVDs AND $2.00 FOR ANY AMOUNT ABOVE THAT For Foreign video orders only : Do you want PAL or NTSC standard tapes? __________ Free shipping on all orders over $100

CREDIT CARD INFORMATION
WE CAN NOT ACCEPT CREDIT ORDERS AT THIS TIME
MAKE ALL CHECKS OR MONEY ORDERS PAYABLE TO CARTER STEVENS

LEGAL DISCLAIMER
I certify by my signature that I am over 21 years of age and that I wish to order the merchandise indicated for my own use at home. I further certify that I am not a city, county, or state or federal law enforcement officer, nor am I an inspector or official of the US Postal Service, ordering this material as evidence for the prosecution or harassment of any individual or organization. My signature below also guarantees that I have not, as of this date, signed US Postal Form 2201 (pursuant to 38 USC 3010) and I hereby warrant that I have no intention of signing said form in the future.


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(Signature) I am 21 years of age, or older. (Date)

Smail - Make checks payable to CSP OR CARTER STEVENS in US. dollars and mail to: Carter Stevens Presents Box 727 Pocono Summit, PA 18346 NOTICE: We do not ship to unsigned orders.