Print this page- fill it out and mail it. Layaway Order Form Name Address Address City State Zip Phone Number Email         Stock # Description Quantity Price Each Total Price                                                                                                                         Shipping   Tax   Total               Layaway Terms We will check the order for correctness and tax and shipping, and mail it or email it back to you with any corrections before the 60 days commences. Buyer wishes to purchase the above mentioned items and pay for them over time. Since we are holding items in good faith we require a non-refundable and non-transferable deposit of $50 plus a one-time administration fee of $10.00. The total balance due must be received in 60 days of the original order date or the layaway will be voided, the items returned to stock and the deposit will be forfeited. A signed layaway form is required. Customer Signature_____________________________________________________________ LAYAWAY PAYMENT TERMS (Please read carefully. If you select layaway, your acceptance of these terms is considered a binding and legal agreement.): 1) The minimum total purchase for a layaway payment plan is $150. Initial ___2) our layaway payment plan requires a minimum deposit of $50 to reserve an item. Please note: Layaway deposits are final and NONREFUNDABLE! These layaway installments are INTEREST FREE!!  It is agreed that there are no refunds under this Layaway installment plan. Initial ___3) to take advantage of this Layaway plan, there is a one-time administration fee of $10.00 to administer your deposit and payments. Initial ___4) your remaining balance is then payable in 4 installments including tax. The maximum allowed layaway payment period is 2 months (60 days). You may pay your total balance off earlier with no penalty. Failure to pay off your entire balance during the 2-month maximum layaway period will result in the cancellation of your order. In addition, if your order is canceled for any reason (by you or Daay - Glow), you will forfeit all funds paid to Daay – Glow.  If Daay – Glow cannot produce your item(s) within 10 business days after your last payment all monies, including deposit and fee will be returned to customer. Initial ___5) Payments must be made in the form of either a Cash, cashier's check, Personal Checks (subject to being cashed) or a money order, or (US dollars only, please). Checks Made Payable to: Daniel Daglow 6) To initiate a layaway plan, print out this page and sign below (indicating your approval of the terms shown above. Sign Customer _______________________________ Date ________________________ Then mail the page with your signature on it and a check for $ 60.00 to : Daay – Glow 10943 Arlington Ave.  Riverside, CA.  92505 or email it to ddaglow@earthlink.net   We only accept Checks, Money Orders.  Cash in Person only.

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