Inventory and Method of Payment Form

Name: __________________________________________________________________

Address: ________________________________________________________________

City: ________________________________ State: ______________ Zip: ____________

Daytime Phone: _____________________ Evening Phone: _________________________

E-mail: __________________________________________________________________

Special Instructions: ________________________________________________________

________________________________________________________________________

How would you like to receive you monsye? (circle one)

Company Check                        Pay Pal                        Bank Wire ($2,500 or more)

Brief description of items: _________________________________________________

_______________________________________________________________________

_______________________________________________________________________

I, the undersigned, hereby state that I am over the age of eighteen (18) years, understand the terms and conditions of the service and am a legal resident of the United States of America. I state to having full ownership of enclosed property and having full authority to resell said property.

Signature: ______________________________________

Date: __________________________________________

Send items to:
APMB, LLC
3001 W Hallandale Beach Blvd - Suite 300
Pembroke Park, Florida 33009
954-252-9041