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¦ Name:_________________________________________Phone Number:_______________¦
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¦ Add:______________________________________________________________________¦
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¦ City:___________________________________________ State:___Zip:____________¦
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¦ Credit Card Information: ¦
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¦ MC or Visa: _________Name on card:________________________________________¦
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¦ Credit card number:____________________________Expiration Date:__/__/_____¦
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¦ John Hodgins ¦ FAX John at 585-343-3613 ¦
¦ 120 Elm Street ¦---------------------------------------¦
¦ Batavia, NY 14020 ¦ E-Mail at john@papersigns.com ¦
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¦ John thanks you for your Paper Sign order. ¦
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