Buyers Name and Address: ............................................................................................. ............................................................................................. ............................................................................................. ......................zip |
Shipping Label (Please fill it out also): ............................................................................................. ............................................................................................. ............................................................................................. ......................zip |
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DATE ORDERED: ________________ |
Sub-Total $__________________ Minus Credit memo $____________________ POSTAGE FEE (SEE CHART BELOW)$_________ TOTAL PAYMENT $__________________ |