This form is for both customers and dealers who want to place their orders online and make payments by PayPal.   When using PayPal we only accept DEBIT card, PayPal CASH payments or direct bank cash PayPal transfers.

You MUST have a valid email address that we can contact you with. If you do not have a valid email address then you should Postal Mail Your Orders To us.  We recommend you send us a "permanent" email address. WE WILL NOT give your email address to anyone.  We are against email spamming and do not tolerate it in any way shape or form! WE WILL NOT use your email address for any solicitation purposes within our company.  We hope you will do the same with our special VIP email address we send to you as well.  Any dealer who is caught using our site or our email addresses in spam will lose their dealership rights... period!

If you do not use PayPal and require another form of payment please email us using our online contact form. I will see what I can do for you.

 Please note that you are responsible for additional fees incurred when and if any errors made based on any information you supply us with  when choosing to use this form of order processing.  When in doubt you should use the "traditional" method of mailing the original order and payment to:
HomeIncome Publishing Group
PO Box 399
Lubec, ME.  04652

NOTE: NOT all the information listed below is required. You may only fill out the information that you think is enough for us to find our original offers' flyer in our office that will match the offer in your hands. The most important information to convey to us is the InfoPAK#, Page #, Flyer/ad Headline, total amount you will pay, total amount your customer paid you and what check boxes your customer has checked on the original order form.  The latter information is usually enough for us to keep things in "check and balanced" and help us prevent order mistakes. If you are new to the Internet or Mail Order just try your best and we will be here to help the best we can for your own success!  With your help we will try our best to help you give your customers the most professional service possible. Regardless of your experience we will help you "look like a PRO"!

YOUR CONTACT INFORMATION:

Please note that if you are a dealer for this offer, this contact information must be the same as that which you are registered under as dealer.

e-Mail Address

Name: 

Address
 

City:
   State:   Zip Code:

Country:

Home Phone (not required):

Please note: We do not offer telephone customer support so we do not make phone calls.  All processing is automatic and all questions can be answered 24/7 via email or via postal mail.  If by postal mail please include an LSASE for reply.

ORIGINAL ORDER FLYER DESCRIPTION INFORMATION:

Note: Because we have many specials and different types of offers. These items help us determine the nature of the flyer/ad of the original offer.

Please state the major headline that stands out most in the flyer that best describes the original offer:

Enter the following items as they apply and if they appear on your original order flyer or ad you can usually find these items someplace in the form.  Enter N/A in the box if you cannot find this information or if it does not apply.
InfoPAK #: (If available, this is usually on the catalog cover or at the bottom of the flyer)

Product Code #: (If available, this is usually in the bottom fill-in part of the order form) OR...

Option # of offer (If available, usually this is a check box in the order form fill-out):

Page # on Flyer (usually the lower right hand corner): (If available, bottom right corner)

Size of original order form (ie., 8x11,  5x8, 1" ad,  2" ad, etc.):

What is printed on the flyer on the very bottom.
(N/A if nothing is there or N/A if you already supplied the other identifying items above ):

PRICING INFORMATION:

Note: This information is to help us better understand more about your order so we get it right.

Are you ordering as a dealer or is this the first time purchase of this offer? (check one)
I am ordering as a dealer.   This is my first time purchase of this offer. 

What does the total payment you are sending represent (check one):
My Dealers cost    My First-Time Retail cost

What is the retail cost represented on the flyer? (ie., $10 +10 F/C Stamps, etc.)

What is the dealer cost represented on the flyer? (ie., $10, 10 F/C Stamps, etc.)

If stamps are involved as part of payment in the offer please multiply the # of stamps required times the current first class postage rates and include that amount in your payment. List here this postage amount.

IMPRINT INFORMATION:

Is there an imprint fee stated on the original order form YES    NO.  If YES then enter the amount you are including here and include that in your payment total.

Is imprint required? YES NO
If so please print the exact details you want imprinted on dealership page(s).
(Please keep this to within 3 lines if possible).

CHECKOUT INFORMATION:

State the Amount you received from the customer (not including stamps or postage)

State number of stamps you received from customer and denomination (if any)

State the Amount you received from the customer (in "non-stamps" cash postage)

Customer hereby affirms and understands that use of this web site and all sales or production request resulting thereof are subject to the Terms and Conditions as outlined in General Policy By submitting this order you are creating and electronic signature and agree to be bound by the terms of this sale. © Copyright [an error occurred while processing this directive]