Fax Order Sheet                          Print this form and send fax to 212-750-3600     BACK

Code  Description Unit Price Qty Extended Price Code  DescriptionSUBTOTAL 1 Unit Price Qty Extended Price
EX SERIES 03395 BODY FIRM FORMULA $70    
03493 LA CREME $500     03814 CITY DAY DEFENSE EMULSION $95    
03438 LA LOTION $200     03299 INTENSIVE HAND TREATMENT $85    
03441 L'EMULSION $280     03436 TREATMENT GLOVES $18    
03904 LA CREME POUR LE CORPS $260     DOUBLE CLEANSING
SENSAI CELLULAR PERFORMANCE 03251 CLEANSING OIL $40    
03713 LOTION I $60     03319 CLEANSING CREAM $40    
03714 LOTION II $60     03322 CLEANSING GEL $40     
03715 EMULSION I $80     03397 CREAMY SOAP $40    
03716 EMULSION II $80     03323 INSTANT FOAM $40    
03717 EMULSION III $80     03428 MILKY SOAP $40    
03719 CREAM $120     03429 PEELING POWDER $50    
03297 EYE BALM $90     03092 SPONGE CHIEF $15    
03298 EYE CREAM $90     OTHERS 
03815 ESSENCE $70              
03718 MASK $60              
03366 THROAT&BUST LIFTING EFFECT $95              

SUBTOTAL 1

  

SUBTOTAL 2

  
Sales Tax:
NY(8.25%), NJ(6%), CT(6%) sales tax applied only to those residents and will be calculated based on the billing address.
Any Question?
Please call toll-free number 1-866-271-6815 or 
write to cosmeticinfo@kanebo.com 		 PRODUCT TOTAL (SUBTOTAL 1+2)  
Shipping & Handling (only within United States)

$ 6  
Total  
Sales Tax  
GRAND TOTAL  

Check enclosed for $
Please charge order to my credit account:  Visa    Master    American Express
 Credit Card Number:   Exp. Date:

Billing Address *Your billing address must match the address on your credit card.  Mailing Address (if different from billing address)
First Name:  　 First Name:  　
Last Name:  　 Last Name:  　
Address:  　 Address:  　
　 　 　 　
City:  　 City:  　
State:  　 State:  　
Zip:  　 Zip:  　
Contact E-mail:  　
Phone:  　 Fax: