Nuts 'R' Us Order Form
First name:
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City:
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Credit Card Number:
Credit Card Expiry Date:
Item
Product Code
Diameter
Length
Colour
Unit Price
Quantity
Ext Price
Bolt
B113
9
50
Black
2.15
Nut
N234
5
NA
Silver
0.45
Washer
W359
8
NA
Silver
0.30
TOTAL: