Fax Form

Three Easy Steps: Print this form, fill it out:

and Fax to: Supie at SUPERLAND - FAX NUMBER (650) 368-7657, 24 hours per day.

Step 1: TELL US WHAT YOU WANT TO BUY or SELL, ENTER THE MOVIE, DVD, GAME, LASER DISC or ADULT VHS/DVD TITLE(s).

Once you tell us what you want to Buy or Sell, we will tell you what it costs, or what we will pay for it, availability shipping costs and any other options.

Title or Description	Format VHS DVD N64 PLA	Qty	Special Features Wide Screen?	New or Pre-Viewed - Either	You Want to Buy or Sell (B) or (S)	Comments
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If you need more room print two sheets.

Format: VHS, DVD, LD, N64, Playstation=PLA, Dreamcast=DRE, Genesis=GEN, Super Nintendo=SNES, Gameboy=GAM
Special Features: Regular=REG, Pan & Scan=P&S, Letterbox=LB Widescreen=WS, THX, Digital Theater Sound=DTS,
Dolby Surround Sound=DSS, etc.
New / Pre-Viewed: New=NEW, Pre-viewed=PVT, Either New or Pre-Viewed=E, (Pre-viewed is Used)

Step 2: Questions and/or how would you like your order shipped?

Step 3: Tell us how to send information requested, back to you: * REQUIRED

NAME: ___ * FAX #: *

PHONE: ___ EMAIL:

MAIL ADDRESS: ___________CITY: _STATE:_ZIP:_________

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Once you tell us what you want to Buy or Sell, we will tell you what it costs, or what we will pay for it, availability shipping costs and any other options.

NAME: _____________________________________ * FAX #: __________________________________ *

PHONE: _____________________________________ EMAIL: __________________________________

MAIL ADDRESS: _____________________________CITY: _____________________STATE:_____ZIP:___________

Author: Super DaveCopyright © 1999-2000 [SUPERLAND]. All rights reserved. Revised: September 17, 2001

NAME: ___ * FAX #: *

PHONE: ___ EMAIL:

MAIL ADDRESS: ___________CITY: _STATE:_ZIP:_________

Author: Super Dave
Copyright © 1999-2000 [SUPERLAND]. All rights reserved.
Revised: September 17, 2001