OnLineArmory.com

Klaus Gehr 151 Hickory Hill Burkeville, Texas 75932 Tel: 337-328-3829 E-mail: klaus@onlinearmory.com

Date: ________________ Contact Name: ________________________________

Ship To: __________________________________________________________

Phone/Fax: ________________ E-Mail: ________________________________

Notes:

QTY	Description	Price	Total
a	:	$	$
b	:	$	$
c	:	$	$
d	:	$	$
e	:	$	$
f	:	$	$
g	:	$	$

SubTotal:	$
Tax 8.25% - Tx only	$
Outside US - add 12% to subtotal	$
Shipping (see order info)	$
Total Amount:	$

Print out this form and mail to the address above. All shipping fees are the sole responsibility of the customer.