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HSM Ammunition Order Statement
This form must be on file before your order can be placed.
Today's Date
MM
/
DD
/
YYYY
Name
*
First
Last
Billing Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Physical Address
*
Same as above
Fill in Physical Shipping Address Below
Physical Shipping Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Phone
*
###
-
###
-
####
Email
Checkbox
*
By checking this box, you certify you are of legal age and satisfy all federal, state and local legal/regulatory requirements to purchase ammunition
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