Page 1 of 2 - Encore Trax Order Form Version 1/23/2015 - Date: ___/___/______ Name: _______________________________________________________________________ Group or Organization: _____________________________________________________ Address1: __________________________________________________________________ Address2: __________________________________________________________________ City: ______________________________________________________________________ State: ________________________________________ Zip: __________-___________ Country: ___________________________________________________________________ Home Ph: (_____) _______ - __________ Home Ph: (_____) _______ - __________ Use Statement Must Be Signed Before Soundtracks Can Be Shipped. I, the above signed purchaser, promise Benson Sound, Inc. that I will not use the soundtracks tapes for any other reason except for live performances, i.e. singing in church or in a concert. I understand they are not to be used for any type of recording without a properly executed Soundtrack Lease Agreement on file and lease payment with Benson Sound, Inc. Signature _________________________________________________________________ Single-Song CD's - Qty 1 $10.00 each* Qty 2-3 $9.50 each* Qty 4+ $9.00 each* Note: All songs come on one CD unless specified otherwise. 10-Song Specialty Packages - CD's Only - $ 37.00 each* ALL CD soundtracks are supplied with All songs on one CD Unless you specify that you use individual CD's with an extra cost of $2.00 per soundtrack. CD & Downloaded tracks cannot be returned because they are custom burned. **Oklahoma Sales Tax Permit number _________________________________ Total Amount of Order $______.____ All orders must include $5.00 per order US Mail shipping & handling fee. **Oklahoma City and /or State Sales Tax will be added unless a vaid sales tax permit # is furnish with order. Customers outside the USA must send and international Money Order in US Funds. A $20.00 charge will be accessed for checks returned for any reason. Prices and Policies are subject to change without notice. Payment Method ( Please check selection below) __ Cash or Check with order __ Money Order __ Visa __ Master Card Complete the section below for Charge Card Purchases Card # ____________________________________________________________ Name on Card (Print) _________________________________________________ Expiration Date _____/______ Signature ______________________________________ Orders can be mailed or faxed to our offices. Benson Sound, Inc. 5717 SE 74th Street Oklahoma City, OK 73135 (405) 610-7455 office (405) 610-7463 fax email: orders@bensonsound.com Page 2 of 2 - Encore Trax Order Form version 2/18/2010 __ I want my Soundtracks on CD Item# Qty Trk# Title Each Ext. ------------------------------------------------------------------------------- 01 ___ _____ _____________________________________ ______ _______ 02 ___ _____ _____________________________________ ______ _______ 03 ___ _____ _____________________________________ ______ _______ 04 ___ _____ _____________________________________ ______ _______ 05 ___ _____ _____________________________________ ______ _______ 06 ___ _____ _____________________________________ ______ _______ 07 ___ _____ _____________________________________ ______ _______ 08 ___ _____ _____________________________________ ______ _______ 09 ___ _____ _____________________________________ ______ _______ 10 ___ _____ _____________________________________ ______ _______ 11 ___ _____ _____________________________________ ______ _______ 12 ___ _____ _____________________________________ ______ _______ 13 ___ _____ _____________________________________ ______ _______ 14 ___ _____ _____________________________________ ______ _______ 15 ___ _____ _____________________________________ ______ _______ 16 ___ _____ _____________________________________ ______ _______ 17 ___ _____ _____________________________________ ______ _______ 18 ___ _____ _____________________________________ ______ _______ 19 ___ _____ _____________________________________ ______ _______ 20 ___ _____ _____________________________________ ______ _______ ============ Oklahoma State Sales Tax Permit # _____________________ Subtotal $ ________ Oklahoma City Residents ADD 3.875% City Sales Tax .................. $ ________ Oklahoma State Residents ADD 4.5% State Sales Tax .................. $ ________ US MAil Shipping & Handling Per Order in USA ($5.00 any qty) ....... $ 5.00 Other Charges ...................................................... $ ________ Canada Shipping Charges ............................................ $ (_______) =========== Total Amount of Order ...... $ ________ Internation orders are only available for Internet Downloads. Orders can be mailed or faxed to our offices. Benson Sound, Inc. 5717 SE 74th Street Oklahoma City, OK 73135 (405) 610-7455 office (405) 610-7463 fax email: orders@bensonsound.com