Fax Completed Form with Copy of State Tax Exemption

FAX COMPLETED FORM WITH COPY OF STATE TAX EXEMPTION

CERTIFICATE

TO 570-759-7275 ATTN: Lori Croop

From: Rebecca Smith / PMG CARDS

Part I

Name of Business:

Billing Address:

City: State: Zip:

Shipping Address:(If Different From Billing)

City: State: Zip:

Primary Telephone:( ) Fax:( )

Principal Owners: E-Mail Address:

Date Business Opened: New Ownership: o YES o NO Date Of Change

PLEASE CHECK AT LEAST ONE OF THE FOLLOWING:

o Charge my first order only to my credit card.

o Charge all orders to my credit card.

For security reasons, an account analyst will contact you for credit card information.

-OR-

o I would like a credit line and terms from Paper Magic Group. (please complete Part II)

TERMS AND CONDITIONS

Any payment received from the purchaser may be applied to Paper Magic Group. The acceptance of such payment shall

not constitute a waiver for the right to pursue any remaining balance. The purchaser agrees that any payment tendered for less

than the full amount of the billing being paid thereby shall constitute an on account payment, irrespective of a contrary

instructions.

The purchaser shall pay all billing not in dispute. The purchaser agrees to pay all cost and expenses, including actual attorneys

fees, expended or incurred as enforcement of this agreement. Any return of product must be authorized.

Checks returned from the bank (N.S.F., Stop Payment, Uncollected Funds) are subject to a $25.00 processing fee.

Your signature (below) authorizes us to open an account for you and if payment terms

have been requested, to conduct a credit investigation in accordance with the

Fair Credit Reporting Act, Public Law 91-508.

______

Signature of Owner, Manager or Buyer Date

Part II

BANK INFORMATION:

Name of Bank: Account #:

Address, City, State, Zip:

Telephone:( ) Fax: ( )

TRADE REFERENCES:

1. Company

Address

City State Zip

Telephone # ( ) Account #

Fax # E-Mail:

2. Company

Address

City State Zip

Telephone # ( ) Account #

Fax # E-Mail:

3. Company

Address

City State Zip

Telephone # ( ) Account #

Fax # E-Mail: