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LAND/Shark
- StealthBag FAX-BACK ORDER FORM
Print out this page. Complete the form below, and fax it to 818-997-0425. The items with * are required in order to process your order properly. Note: Please include your Name EXACTLY as it appears on your Credit Card, and provide your Credit Card BILLING ADDRESS in the fields below. If you require a different "Ship To" address, include that information in the "Comments or Questions" section below. |
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*
Name:
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*
Address:
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Address:
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*
City, State, Zip:
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*
Country:
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*
Telephone Number:
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Fax
Number:
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*
E-Mail Address:
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Payment Method:
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____ Visa ____ MC ____ AMEX |
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*
Credit Card Number:
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*
Expiration Date:
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(MM - YY) _______ / _______ |
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Quantity
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Product
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Unit
Cost
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Extension
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#
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LAND/Shark
- StealthBag
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$69.95
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$
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#
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Nylon
Carry and Storage Pouch
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$6.95
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$
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This
is a Limited Time Offer. Prices subject to change without notice.
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Sub
Total:
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$
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Sales
Tax:
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$
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Shipping:
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$
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Foreign
Shipping:
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TBD
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Total:
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$
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Comments
or Questions:
___________________________________________________________ ___________________________________________________________
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| Click here to return to the LAND/Shark StealthBag ORDERING CENTER |