Please print out and confirm your order by filling in the information, signing, and returning it via mail with cash, check or money order to:
P.P. or Vita-Vid
2375 E. Tropicana Ave. #777
Las Vegas, Nevada 89119
Orders cannot be shipped without written
confirmation.
As soon as this signed confirmation is received you order will be processed
and shipped to you.
E-Mail:
Billing Address
Shipping Address
Video #
Name
Format
Qty
Price
Item Total
______________________
______________________
______
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35.00
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______________________
______________________
______
______
35.00
______
______________________
______________________
______
______
35.00
______
______________________
______________________
______
______
35.00
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______________________
______________________
______
______
35.00
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$15.00 Check box for Panties used in videos __________________
$15.00 Check box for Photos __________________
Not all girls have photos or panties left. Please name several options.
Visa Master Card:
Card Holder's Name:
Credit Card Number:
Exp: ______
Total $___________
Yes, I placed this order and I authorized my Credit Card # listed above
to be charged in the amount of $__________. I realize I am ordering video tape(s)
which show sexually explicit, conduct. These materials will be used solely for
my personal enjoyment, and shall not be resold, duplicated, or commercially displayed.
I will never let these materials be shown to persons who do not wish to view sexually
explicit materials, or to minors.
I AM TWENTY-ONE YEARS, OR OLDER.
I declare under penalty of perjury that the foregoing is true and correct.
Executed this ______ day of ____________, Year ________, in the County of __________________________,
in the state of _______