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Phone Your Order	Fax Your Order	Mail Your Order
Phone your order in: Mon - Fri. / 10 - 5 pm Eastern Time Zone +1-517-857 4383	Print and fill out form. Fax to: +1-517-857 2112	Print and fill out form. Mail to: Tallcoat Corporation 23848 27 1/2 Mile Rd Springport, MI 49284-9426 USA

Product Code	Quantity	Description (Color, Size etc....)	Price Each	Total

Visa

MasterCard

Discovery

American Express

Sub Total
Sales Tax 6%
Shipping
Order Total

Card Number
Expiration Date
Signature

The address provided here must match your credit card billing address. Complete Physical Addresses Only, no P.O. Boxes please. This is an additional security feature for your protection and safeguard.

Billing Information (Please use Card Holder's name and address)
Name
Address
Phone
E-mail

Shipping Information (Fill only if different from Billing Address)
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Address
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