













Processing Instructions

Please print this form & mail with payment to the following address. 
Denny's Outlet
, 700 S. Main, Three River, MI. 49093
1-616-273-1442, e-mail: dennysoutlet@hotmail.com
Please make a copy for your records before mailing your products.
NAME: ____________________________________
ADDRESS: ____________________________________
____________________________________
CITY, STATE: ___________________________________
ZIP CODE: _________________
E-MAIL ADDRESS: ________________________________
PHONE #: ____________________________
QUANTITY
OF CD'S SENDING FOR REPAIRS: ________
@ WHAT COST PER CD, EQUALS = $ ______
UPS SHIPPING & HANDLING CHARGES: $_______
TOTAL AMOUNT ENCLOSED WITH SHIPMENT: $__________
Credit card # : ___________________________________
Expiration date: _____________, Card Type: ______________
Cardholders signature: ______________________________
Cardholders Printed Name: _____________________________________
We have approximate 48 hours turn around upon receipt of your cd's on orders of all credit cards, casher checks, & money orders. All business & personal check processing will be after check clears the bank.
