Page 1 of 2 - Encore Trax Order Form Version 2/18/2010 - 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. 3900 East I-240 Oklahoma City, OK 73135 (405) 670-4461 office (405) 670-4778 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. 3900 East I-240 Oklahoma City, OK 73135 (405) 670-4461 office (405) 670-4778 fax email: orders@bensonsound.com