ORDER
REPLY FORM
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| Subtotal: |
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| S&H: |
$10.00 |
| C.O.D.: |
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| Texas Res.
add 8% Tax: |
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| Grand
Total: |
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Name:___________________________
Address:_________________________
City:_________________
State:_________________Zip:________
Phone:___________________
[__] Visa [__] MasterCard
#____________________________
Expires____________
Signature:____________________________________
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