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Web www.bassarts.com
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QUANTITY
DESCRIPTION
UNIT PRICE
TOTAL
NOTES
SUB TOTAL

NY Sales Tax 8%
SHIPPING & HANDLING
TOTAL
PAYMENT
Check
Send check or money order to:
BASSARTS
PO Box 213
Rifton, NY 12471
Money Order
REFERRAL
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BILLING ADDRESS
Name:
Street:
City:
State:
Zip:
Country:
Phone:
E-mail:

SHIPPING ADDRESS
Same as Billing
Name:
Street:
City:
State:
Zip:
Country:
Phone:
E-mail:
or