Please print out this form and mail with check or money order to Michael Barretta 478 E. ALTAMONTE DR. ,SUITE 108 PMB 314 ALTAMONTE SPRINGS, FL 32701-4622 --=---=---=---=--=--=--=--=--=--=---=--=--=--=--=--=--=--=---=--=---=--=---=-- This Bust makes a wonderful addition to any Home, Office, School, Public Building or Library. ABRAHAM LINCOLN SCULPTED BUST Shipped to U.S. address $149.99 plus $14.99 FEDEX shiping & packing US adderss no PO Boxs Please Total = $164.98 US Dollars make check or money order payable to Michael Barretta PLEASE PRINT NAME ___________________________________________________________ ADDRESS ________________________________________________________ CITY ____________________________ STATE ___________ ZIP _________ Telephone Number ( _____ ) _____-________ E-mail ______________