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Please Print and fax or mail to us. It has to be signed.
Minimum Order: $30.00
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Date:
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mojomagic.com
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Name:
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3473 N. Oakland Ave.
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Street Address:
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Milwaukee, WI 53211
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City: State: Zip:
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Ph: 1-414-961-9162
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Phone:
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Fax: 1-414-482-7419
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Fax:
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e-mail: mojomagic@bigplanet.com
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e-mail:
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Item Name:
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Qty:
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Description
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UnitPrice
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Total
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Subtotal
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Shipping
& Handling
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Taxes 5.6%
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Total
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Circle One: MasterCard Visa American Express Check
Money Order
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Credit Card No:
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Exp. Date
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Name As It Appears On Card:
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Name Of Issuing Bank:
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800 Number Of Issuing Bank:
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Signature:
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No Exchanges on Spiritual Items. Total
Minimum order $30.00. Insurance
(optional)(recommended) $1.00. $25.00 Fee on Returned Checks. Overseas
additional fees apply.
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