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for $495, plus $10 S&H

Charge my:        Visa          Mastercard          Discover
(Note: You can use more than one card to complete this order)

Card Number:____________________________________ Exp. Date:______________

Signature: __________________________________________

Print Name: __________________________________________

Address: __________________________________________

City: _____________________________ State: ___________________________

Zip Code: _______________________ Country: __________________________________

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Or Mail This Form To:

Jim Fortunato

111 Heilig Road

Sewell, NJ  08080

You may also call: 1-856-343-4722 to place your order by phone 24-Hours a day.

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