Order Form

Please complete and print this form (or a facsimile thereof) to include with full payment for your order:

Your information

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Order and Payment information

Payment of twenty U.S. dollars ($20) per set as

Payments are only accepted in U.S. dollars, or by check or money order (payable to "Bernard Karmilowicz") for same. A $30 fee will be assessed for each returned ("bounced") payment. Product is not shipped until payment clears.

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