CHECK/MONEY ORDER FORM

We will accept personal checks or money orders as payment for products. Please fill in the information below, print out the form, and attach a check or money order* for the total amount of your order, including delivery charge. (New York State residents must also add 8 percent sales tax.)

1. Complete and then print out this form:

First Name
Last Name...
Mailing Address
Email address
Home Phone Number (optional)
Product Code Number/s; Quantity (#)
  Example: AN-1 (1) ; VE-2 (3)

2. Add the correct delivery charge to your product total:

Delivery Charges

If Your Order Totals Delivery Charges
Up to $ 25 $ 6.00
$ 25.01 to $ 45.00 $ 7.50
$ 45.01 to $ 75.00 $ 9.00
$ 75.01 to 100.00 $ 12.00
$ 100.01 and over $ 14.00

3. New Yorkers, please include 8.5% sales tax

4. Send this form with your payment to:

Mosaicdetails
P.O. Box 796
Westhampton, NY 11977

Make checks/money orders in U.S. Funds only and payable to "".

*Checks/money orders in US funds only, and payable to Mosaicdetails.
You will be notified via email once your order has been processed.

Thank you.