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NAME__________________________________________________________________
SHP. ADDR.______________________________________________________________
________________________________________________________________________
STATE/CITY/ZIP__________________________________________________________
PHONE#____________________________________________
YOUR EMAIL ADDRESS____________________________________________________
------QTY----------- ITEM #-------------------------------DESCRIPTION-----------------------------TOTAL $
SUB TOTAL____________________
TOTAL SHIPPING OF EACH ITEM____________________
SALES TAX-WI. RES. ONLY- 5.5%___________________
GRAND TOTAL___________________