Finesse Collection, Inc.      DATE OF ORDER  ____/____/____      NEW ACCOUNT __

10235 Brookville Lane             Voice: 561-483-6522               CUST.P.O. # __________________      EXIST. ACCT     __

Boca Raton, FL  33428           Fax:    561-483-0315              TERMS:   NET 30 ___  COD  ___  PREPAID ___

                E-mail: sales@finessecollection.com                        

        www.finessecollection.com                               MC / VISA / AMEX #                                                                  

SALESPERSON:                                                                     NAME / EXP. DATE:                                                                 

BILL TO:                                                                                 SHIP TO:                                                                                                 

PHONE:                                                               FAX:                                                                                          

CUSTOMER SIGNATURE                                                                                                                                                    

SPECIAL INSTRUCTIONS