Lexington House Fax Order Form
Please Print & Fax Back 24 Hours Fax 1-812-988-6613

Please note...Indiana sales tax is now 6%

Billing name

Billing address

City, State, Zip

Card Type & Expiration Date

Card Number

Phone Number

E-mail address

Shipping name

Shipping address

City, State, Zip

Bob & Chris Thank You

You will receive an e-mail confirmation of your order
with the total cost including shipping
and estimated delivery time within 24 Hours

E-mail LexHsNash@aol.com