Please provide the following ordering information:

Quantity Ordered	Description	Price
	1/2 oz. Mini Shad	4.95 ea.
	3/4 oz. Baby Shad	4.95 ea.
	1-1/2 oz. Shad Minnow	5.95 ea.
	2 oz. Shad Minnow	5.95 ea.

Order Value	Standard Shipping Continental U.S.
$10.00 - $20.00	$4.95
$20.01 - $40.00	$5.95
$40.01 - $60.00	$6.95
$60.01 - $90.00	$7.50
$90.01 - $125.00	$7.95

Please fill in the fields below based on your order

Total Merchandise Ordered
Postage & Handling	$4.95 $5.95 $6.95 $7.50 $7.95   see chart above
Subtotal
Utah  Residents add 6.40% sales tax on Subtotal
Total
Minimum order is $10.00

* 10% Federal Excise Tax is included in price
Send Cashiers Check or Money Order,
payable to:
Wallylures L.L.C.
1073 N. 450 W.
Sunset, UT 84015

Cashiers Check or Money Order will expedite shipments, 
as it is necessary for personal checks to clear the banks before shipment.

(* Asterisks indicate the fields that are required to be filled in)

	BILLING
Purchase order #
Account name

	SHIPPING
*Full Name
*Address
*City
*State/Province
*Zip/Postal code
*Country

Work Phone
Home Phone
FAX
E-mail
URL