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P.O. BOX 1740, WATSONVILLE, CA 95077 PHONE (831) 761-0566 – PHONE/FAX (831) 761-0455 DEPOSIT RECEIPT PLEASE PRINT DATE___________________ NAME_____________________________________________________ HOME PHONE____________________ WORK PHONE___________________________________ CELL PHONE _____________________ EMAIL ADDRESS________________________________ STREET ADDRESS____________________________________________ APT # ________________ CITY____________________________ STATE___________________ ZIP ___________________ TYPE OF BIRD____________________________________ PRICE OF BIRD________________ TYPE OF BIRD____________________________________ PRICE OF BIRD________________ TAX (CA RESIDENTS – 7.25%)__________________________ SEX WANTED: MALE ( ) FEMALE ( ) IF YOU ARE HAVING YOUR BABY SHIPPED DO YOU WANT IT VET CHECKED BEFORE WE SHIP? TESTING INCLUDES: Office visit, Avian Blood Panel and Gram Stain. YES ( ) NO ( ) BIRD TOTAL $_________________ TESTING $________________ TOTAL $________________ A NON-REFUNDABLE 1/3 OF THE COST OF THE BIRD IS THE REQUIRED DEPOSIT BY THE TIME YOUR BABY IS 3 WEEKS OLD. THIS 1/3 DEPOSIT IS NON-REFUNDABLE UNLESS THE BIRD IS UNDELIVERABLE. “UNDELIVERABLE” MEANS NO STOCK FOR SALE. METHOD OF PAYMENT: CHECK ( ) CASH ( ) CREDIT CARD ( ) CREDIT CARD #__________________________________ EXP. DATE_______________________ NAME ON CARD__________________________________ AMOUNT OF DEPOSIT PAID (MINIMUM $50.00) $___________________________ REMAINING 1/3 DEPOSIT (DUE AT 3 WEEKS OF AGE) $___________________________ BALANCE DUE AFTER 1/3 DEPOSIT $___________________________ THIS 1/3 DEPOSIT IS NON-REFUNDABLE UNLESS BIRD IS UNDELIVERABLE NO REFUNDS IF YOU CANCEL SIGNATURE_______________________________________ DATE________________________
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