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P.O.BOX 1689 MOUNTAIN HOME, NC 28758 E-mail brian@faithassociates.com |
NAME....................................................................... ADDRESS.................................................................. CITY,STATE,ZIP.......................................................... PHONE NUMBER.......................................... |
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24hr Fax 828-697-6827 my cell 828-674-2774 |
EXP.DATE............................ V-code (last 3 digits on the back of the CC on signature panel)............ |
MC..... VISA.. |
NUMBRER |
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