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To Order Call: (405) 344-8137 or Fax to (405) 344-6592 Email: CustomerService@cinchhook.com Mailing Address: Jack and Mindy Horsey 11318 State Highway 39 Blanchard, OK 73010
Date: __________________________ P.O. # ______________________________
Bill To: Ship To:
Name: _________________________ Name: ______________________________
Company: ______________________ Company: ___________________________
Address: _______________________ Address: ____________________________
City: __________________________ City: _______________________________
State: ____________ Zip: ________ State: _______________ Zip: ___________
Phone Number: _______________________________
Qty: (Single) ______________ Requested Ship Date: ____________________
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