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mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} </style> <![endif]--><!--[if gte mso 9]><xml> <o:shapedefaults v:ext="edit" spidmax="2050"/> </xml><![endif]--><!--[if gte mso 9]><xml> <o:shapelayout v:ext="edit"> <o:idmap v:ext="edit" data="1"/> </o:shapelayout></xml><![endif]--> </head> <body lang=EN-US link=blue vlink=purple style='tab-interval:.5in'> <div class=Section1> <p style='margin-bottom:3.75pt'><span class=SpellE><b><i><span style='font-size:36.0pt'>Caren's</span></i></b></span><b><i><span style='font-size:36.0pt'> Cake Cottage<span style='mso-tab-count:4'>                </span><span style='mso-tab-count:1'>    </span></span></i><!--[if gte vml 1]><v:shapetype id="_x0000_t136" coordsize="21600,21600" o:spt="136" adj="10800" path="m@7,l@8,m@5,21600l@6,21600e"> <v:formulas> <v:f eqn="sum #0 0 10800"/> <v:f eqn="prod #0 2 1"/> <v:f eqn="sum 21600 0 @1"/> <v:f eqn="sum 0 0 @2"/> <v:f eqn="sum 21600 0 @3"/> <v:f eqn="if @0 @3 0"/> <v:f eqn="if @0 21600 @1"/> <v:f eqn="if @0 0 @2"/> <v:f eqn="if @0 @4 21600"/> <v:f eqn="mid @5 @6"/> <v:f eqn="mid @8 @5"/> <v:f eqn="mid @7 @8"/> <v:f eqn="mid @6 @7"/> <v:f eqn="sum @6 0 @5"/> </v:formulas> <v:path textpathok="t" o:connecttype="custom" o:connectlocs="@9,0;@10,10800;@11,21600;@12,10800" o:connectangles="270,180,90,0"/> <v:textpath on="t" fitshape="t"/> <v:handles> <v:h position="#0,bottomRight" xrange="6629,14971"/> </v:handles> <o:lock v:ext="edit" text="t" shapetype="t"/> </v:shapetype><v:shape id="_x0000_i1025" type="#_x0000_t136" alt="ORDER FORM" style='width:230.25pt;height:36pt' fillcolor="black"> <v:shadow color="#868686"/> <v:textpath style='font-family:"Bookman Old Style";font-size:32pt; font-weight:bold;v-text-kern:t' trim="t" fitpath="t" string="ORDER FORM"/> </v:shape><![endif]--><![if !vml]><img width=309 height=50 src="order_form_files/image002.gif" alt="ORDER FORM" border=0 v:shapes="_x0000_i1025"><![endif]>&nbsp;&nbsp;&nbsp;&nbsp;<o:p></o:p></b></p> <p style='margin:0in;margin-bottom:.0001pt'>&nbsp;</p> <p style='margin:0in;margin-bottom:.0001pt'><span class=style31><span style='font-size:14.0pt'>7475 Lamar Ave South · Cottage Grove, Minnesota 55016</span></span><span style='font-size:14.0pt'><o:p></o:p></span></p> <p class=style3 style='margin:0in;margin-bottom:.0001pt'><span style='font-size:14.0pt'>(651) 459-4460 · (888) 988-4460 · Fax (651) 459-7920<o:p></o:p></span></p> <p style='margin:0in;margin-bottom:.0001pt'><span class=style21><span style='font-size:14.0pt'>Email: </span></span><span style='font-size:14.0pt'><a href="mailto:kmfritze@comcast.net"><span class=style21><span style='mso-ansi-font-size: 14.0pt;mso-bidi-font-size:14.0pt'>kmfritze@comcast.net</span></span></a><span class=style21><span style='mso-ansi-font-size:14.0pt;mso-bidi-font-size:14.0pt'>&nbsp;&nbsp;&nbsp; Web Site: www.cakestands.com</span></span><o:p></o:p></span></p> <p><b><span style='font-size:13.5pt'><o:p>&nbsp;</o:p></span></b></p> <p><b><span style='font-size:13.5pt'><o:p>&nbsp;</o:p></span></b></p> <p><b><span style='font-size:13.5pt'>Billing Address&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Shipping Address (If different than shown on left)</span><o:p></o:p></b></p> <p style='margin:0in;margin-bottom:.0001pt'><b><span style='font-size:13.5pt'>__________________________________________________________&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ___________________________________________________________</span><o:p></o:p></b></p> <p style='margin-top:2.25pt;margin-right:0in;margin-bottom:0in;margin-left: 0in;margin-bottom:.0001pt'><b><span style='font-size:10.0pt'>Name&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Name</span><o:p></o:p></b></p> <p style='margin-top:7.5pt;margin-right:0in;margin-bottom:0in;margin-left:0in; margin-bottom:.0001pt'><b><span style='font-size:13.5pt'>__________________________________________________________&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ___________________________________________________________</span><o:p></o:p></b></p> <p style='margin-top:2.25pt;margin-right:0in;margin-bottom:0in;margin-left: 0in;margin-bottom:.0001pt'><b><span style='font-size:10.0pt'>Address&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Address</span><o:p></o:p></b></p> <p style='margin-top:7.5pt;margin-right:0in;margin-bottom:0in;margin-left:0in; margin-bottom:.0001pt'><b><span style='font-size:13.5pt'>__________________________________________________________&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ___________________________________________________________</span><o:p></o:p></b></p> <p style='margin-top:2.25pt;margin-right:0in;margin-bottom:0in;margin-left: 0in;margin-bottom:.0001pt'><b><span style='font-size:10.0pt'>City&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; City</span><o:p></o:p></b></p> <p style='margin-top:7.5pt;margin-right:0in;margin-bottom:0in;margin-left:0in; margin-bottom:.0001pt'><b><span style='font-size:13.5pt'>__________________________________________________________&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ___________________________________________________________</span><o:p></o:p></b></p> <p style='margin-top:2.25pt;margin-right:0in;margin-bottom:0in;margin-left: 0in;margin-bottom:.0001pt'><b><span style='font-size:10.0pt'>State&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Zip&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; State&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Zip</span><o:p></o:p></b></p> <p style='margin-top:7.5pt;margin-right:0in;margin-bottom:0in;margin-left:0in; margin-bottom:.0001pt'><b><span style='font-size:13.5pt'>__________________________________________________________&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ___________________________________________________________</span><o:p></o:p></b></p> <p style='margin-top:2.25pt;margin-right:0in;margin-bottom:7.5pt;margin-left: 0in'><b><span style='font-size:10.0pt'>Phone Number&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Phone Number</span><o:p></o:p></b></p> <p style='margin-top:2.25pt;margin-right:0in;margin-bottom:7.5pt;margin-left: 0in'><b>&nbsp;<o:p></o:p></b></p> <table class=MsoNormalTable border=1 cellspacing=1 cellpadding=0 width=1099 style='width:824.25pt;mso-cellspacing:.7pt;mso-yfti-tbllook:1184;mso-padding-alt: 5.25pt 5.25pt 5.25pt 5.25pt'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td width="13%" valign=top style='width:13.0%;background:white;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p align=center style='text-align:center'>Item Number</p> </td> <td width="9%" valign=top style='width:9.0%;background:white;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p align=center style='text-align:center'>Quantity</p> </td> <td width="55%" valign=top style='width:55.0%;background:white;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p align=center style='text-align:center'>Description</p> </td> <td width="9%" valign=top style='width:9.0%;background:white;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p align=center style='text-align:center'>Unit Price</p> </td> <td width="9%" valign=top style='width:9.0%;background:white;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p align=center style='text-align:center'>Total Price</p> </td> </tr> <tr style='mso-yfti-irow:1'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:2'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:3'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:4'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:5'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:6'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:7'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p align=right style='text-align:right'>&nbsp;</p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p align=center style='text-align:center'>&nbsp;</p> </td> </tr> <tr style='mso-yfti-irow:8'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:9'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p align=right style='text-align:right'>&nbsp;</p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:10'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:11'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:12'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:13'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:14'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:15'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:16;mso-yfti-lastrow:yes'> <td width="13%" valign=top style='width:13.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="55%" valign=top style='width:55.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p align=center style='text-align:center'>10% Restocking Fee on Returned Orders</p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> <td width="9%" valign=top style='width:9.0%;padding:5.25pt 5.25pt 5.25pt 5.25pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> </table> <p class=MsoNormal><b><span style='mso-fareast-font-family:"Times New Roman"; display:none;mso-hide:all'><o:p>&nbsp;</o:p></span></b></p> <table class=MsoNormalTable border=1 cellpadding=0 width=1099 style='width: 824.25pt;mso-cellspacing:1.5pt;mso-yfti-tbllook:1184' height=138> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td rowspan=3 valign=top style='padding:.75pt .75pt .75pt .75pt'> <p class=MsoNormal><b><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; METHOD OF PAYMENT</span></b><span style='mso-fareast-font-family:"Times New Roman"'><o:p></o:p></span></p> <p><b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </b><b><span style='font-size:18.0pt'>¡%</span>&nbsp;&nbsp;&nbsp; Check&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </b><b><span style='font-size:18.0pt'>&nbsp;¡%</span>&nbsp;&nbsp; Visa&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ________________________________________________________________</b></p> <p style='margin-top:0in'><b>&nbsp; </b><span style='font-size:10.0pt'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Credit Card Number</span></p> <p><b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </b><b><span style='font-size: 18.0pt'>¡%</span>&nbsp;&nbsp; MasterCard&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </b><b><span style='font-size:18.0pt'>¡%</span>&nbsp;&nbsp;&nbsp; Discover Card&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ________________________________________________________________</b></p> <p style='margin-top:0in'><b>&nbsp;&nbsp; </b><span style='font-size:10.0pt'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Expiration Date</span></p> <p><b>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ________________________________________________________________</b></p> <p style='margin-top:0in'><b>&nbsp;</b><span style='font-size:10.0pt'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Signature</span></p> </td> <td width=98 style='width:73.5pt;padding:.75pt .75pt .75pt .75pt'> <p class=MsoNormal><b><span style='font-size:10.0pt;mso-fareast-font-family: "Times New Roman"'>Shipping &amp; Handling</span></b><span style='mso-fareast-font-family: "Times New Roman"'><o:p></o:p></span></p> </td> <td width=97 style='width:72.75pt;padding:.75pt .75pt .75pt .75pt'> <p class=MsoNormal><b><span style='font-size:10.0pt;mso-fareast-font-family: "Times New Roman"'>$15.00</span></b><span style='mso-fareast-font-family: "Times New Roman"'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:1'> <td width=98 style='width:73.5pt;padding:.75pt .75pt .75pt .75pt'> <p class=MsoNormal><b><span style='font-size:10.0pt;mso-fareast-font-family: "Times New Roman"'>MN Residence Add 6.5 % Sales tax</span></b><span style='mso-fareast-font-family:"Times New Roman"'><o:p></o:p></span></p> </td> <td width=97 style='width:72.75pt;padding:.75pt .75pt .75pt .75pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:2;mso-yfti-lastrow:yes;height:48.0pt'> <td width=98 style='width:73.5pt;padding:.75pt .75pt .75pt .75pt;height:48.0pt'> <p align=center style='text-align:center'><b><span style='font-size:13.5pt'>Total</span></b></p> </td> <td width=97 style='width:72.75pt;padding:.75pt .75pt .75pt .75pt;height: 48.0pt'> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p> </td> </tr> </table> <p class=MsoNormal><span style='mso-fareast-font-family:"Times New Roman"'><o:p>&nbsp;</o:p></span></p> </div> </body> </html>