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Name _____________________________________________________________________________
eMail ___________________________________
Shipping Address _________________________________________________________________
City ___________________________________ State ______________ ZIP ______________
Daytime Phone __________________________ Fax ____________________________
Signed __________________________________________________________________
How did you hear about us? _______________________________________________________
__________________________________________________________________________________
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Description:
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Quantity |
Price |
Total |
| Company Property |
|
|
|
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| Treasure Box |
Deluxe |
Numbered Edition |
_________ |
$150.00 |
_________ |
| Black Bart |
Hard Cover |
|
_________ |
$99.00 |
_________ |
| Messenger Twelve |
Hard Cover |
|
_________ |
$12.00 |
_________ |
| Hardware Item: |
___________________ |
________________ |
|
|
_________ |
| Sales Tax |
CA Residents: |
Please Add: |
|
7.75% |
_________ |
| Shipping & Handling Is Included |
|
|
|
Total = |
_________ | |