The Earth Pigments Company  www.earthpigments.com
PO Box 1172 • Cortaro, AZ 85652 • USA  (520) 682-8928  info@earthpigments.com
NAME  
ADDRESS  
CITY & STATE/PROV.  
ZIP or POSTAL CODE        USA     CANADA
PHONE   EMAIL  
Qty Prod # Prod Name Color
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Subtotal  
5.6% Tax (Arizona Addresses ONLY)  
Note: please call or email for charges - we ship to US and Canada Only.  Shipping  
TOTAL  
Payment Info
Payment Method: Check/Money Order Visa MasterCard American Express
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   Expire Date  
Signature
  
US Checks, US Money Orders, Visa, Mastercard, American Express only.