Stunning Defense Enterprises Self Defense Products 423 S. Main Street Telford, PA 18969 Phone 267.450.8055 www.StunningDefense.com e-mail: CustomerService@StunningDefense.com Date: Name: Name: Ship To Address: Billing Address: Email Address: Phone Number: QUANTITY MODEL NUMBER AND DESCRIPTION UNIT PRICE AMOUNT SUBTOTAL PENNSYLVANIA RESIDENTS MUST INCLUDE SALES TAX (6.0%) THERE IS A $6.95 SHIPPING & HANDLING CHARGE FOR ORDERS LESS THAN $100.00 TOTAL DUE Name on Credit Card______________________________ Personal Check, USPS Money Order, or Credit Card. Credit Card Type_________________________________ Make check payable to: Stunning Defense Enterprises CC#_______________________________CCV________ VISA, MasterCard, Discover, American Express Expiration Date__________________________________ THANK YOU FOR YOUR ORDER! Signature_______________________________________ It is the buyer's responsibility, not the seller's, to ascertain and obey all applicable local, state, and federal laws regarding the possession and use of any item offered by Stunning Defense Enterprises. If you are unsure, please contact your local or state authorities. By placing an order, the buyer represents that all products purchased will be used in a lawful manner and that he/she is of legal age. If you have any questions, call 267-450-8055 or e-mail CustomerService@StunningDefense.com.