Products Price Quantity Total

Products		Price	Quantity	Total
	PCC Sub Box Monthly Subscription Box charged on the 10th, shipped on the 1st.	$39.99	1	$39.99
Subtotal			$39.99

PCC Sub Box

Monthly Subscription Box charged on the 10th, shipped on the 1st.

$39.99

Subtotal $39.99

Billing Information
* First Name
* Last Name
Company Name
* Address - Line 1
Address - Line 2
* City
State
* Zip Code
* Country
* Phone Number
* Email Address
Shipping is the same as billing

Shipping Options
$9.97 Standard Shipping $29.99 Rush Shipping

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