Kentucky Barrels

Mail in Credit Card Order Form  Visa, Master Card, or Discover Card

For more information email: kybarrelquote@gmail.com
Email:
kybarrelquote@gmail.com
Kentucky Barrels  -  PO Box 160 Bryantsville  Kentucky 40410
 
TO ORDER:
Before you order make sure read and understand our sales terms. By placing an order you agree to our sales terms. Click here to read terms

Please print this page using the "print" function on your browser, fill it out, and send it along with check or money order to:
mail to:
Kentucky Barrels
 
P.O. Box 160
Bryantsville, Ky 40410
When you are finished printing, use the "back" function of your browser to return to the last page viewed.
Card Type:  Visa:________  Master Card:________  Discover Card:________ 

CARD NUMBER:__________________________________________________________________________

Expiration Date:______________________       
CVV2::____________________
 
CVV2 is a 3-digit number  at the end of the credit card number on the signature panel on the back of the credit card, and 4 digits on the front of an American Express card
NAME Of CARD HOLDER:____________________________________________________________________________________

ADDRESS OF CARD HOLDER:

       Street:____________________________________________________________________________________________________

       City:   ____________________________________________________________________________________________________

       State:  _____________________   Zip Code:___________________
SHIP TO (if different from above)

       Business Name:_____________________________________________________________________________________________

       Street:_____________________________________________________________________________________________________

       City:   _____________________________________________________________________________________________________

       State:  _____________________   Zip Code:___________________

PHONE:____________________________  EMAIL ADDRESS: ________________________________________________________
I have read and agree to Kentucky Barrel ordering terms, sign here:_________________________________________
Please send me
QTY
ITEM
UNITS
DESCRIPTION
UNIT PRICE
SHIPPING
TOTAL
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______________________
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SUBTOTAL
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KY RESIDENTS AD 6% SALES TAX

 
 

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TOTAL
_________ __________
By placing an order you agree that you have read and understand our ordering terms
CLICK HERE TO READ ORDERING TERMS


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