To order

Ship to_____________________________________

Street______________________________________

City__________________________State____________Zip__________

Unit Quantity	Plan Order Number	Description of Item	Unit Price	Total





Sub Total
Mailing Tube				$5.00
Add 10% for Postage & Handling, Minimum $4.65 All Foreign Orders, Please Add 50% for Postage & Handling, Minimum $35.00
West Virginia Residents Please Add 6% Sales Tax
Total Amount of Order

phone number:_____________________________
Send Check or Money Order and Mail to:
The Maryland Silver Co.
P.O. Box 581
Craigsville, WV 26205