RCM VIDEO PRODUCTS
Mini-Punch Ps-55
ORDER FORM
Please fill out this form, print it out, and send it along with your payment.

Name
Shipping Address
Shipping Line 2
CITY
STATE
POSTAL ZIP CODE
Please select the quantity
of "Mini-Punch Ps-55"
you are ordering

Please complete this form and print it out and mail it along with your total payment of
$149.95 + (your shipping method choice)

and send it to:

RCM Mini-Punch Ps-55
Robert Moseley
6925 Clift St.
North Richland Hills, Texas 76180

Make checks and money orders out to:
"Robert Moseley".
Personal checks subject to bank verification before shipping.

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