Please print this form and mail it with your check to the address below. Wholesale orders may be e-mailed directly to us; attach your order in any format you like. If you have any questions, please e-mail us:

Bombshelter Press PO Box 481266 Bicentennial Station Los Angeles, CA 90048 USA http://www.bombshelterpress.com Quantity Item Unit Price Total Subtotal California residents add 8.25% sales tax Shipping/handling: $2.00 for first item; .50 for each additional item. TOTAL Notes/comments/clarifications Name Address Line 1 Address Line 2 City State ZIP Country E-mail Address (not required) Phone (not required)

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