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Daron Enterprises Order Form
for persons using check or money order.

Please Print

Name                                                                Date
 
Address

City		                      	State                                          Zip
Order Information
Quantity Description Unit Price Amount
(a) a $ $
(b) b $ $
(c) c $ $
(d) d $ $
(e) e $ $
(f) f $ $
(g) g $ $
One to six items Shipping and Handling $4.95 $
Seven to twelve items Shipping and Handling $14.95 $
SUBTOTAL $
Nebraska residents,
please add correct SALES TAX		 $
TOTAL $

Please allow three weeks for delivery.

Please mail order to:

Daron Enterprises
9367 Ellison Ave
Omaha, NE 68134

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