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ORDER FORM , Wild
Bill Video......
Add Title and price--Check......DVD
#1_________________________________________$_______DVD________
#2_________________________________________$_______DVD________
#3_________________________________________$_______DVD________
#4_________________________________________$_______DVD________
#5_________________________________________$_______DVD_______
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LEGAL DISCLAIMER: I the undersigned herby direct WILD BILL VIDEO
to mail me all brochures catologs,videotapes. I realize that
these items may be considered SEXUALLY EXPLICIT. I DO NOT want
the notice Sexually oriented material written on the package
or envelope mailed to me. I am an adult 21 years old or older,I
am purchasing these sexually oriented material for my private
use in my own home. I will not show or sell them to minors. I
am not ordering this material as evidence for prosecution. I
have not as this date signed U.S.POSTAL FORM 2201(pursuant to
38 usc3010). I believe that this material does not offend the
community standards in my ordering area. Make CHECKS OR MONEY
ORDERS PAYABLE TO: WILD BILL VIDEO.MAIL TO:WILD BILL ,PMB #308
,3450 PALMER Drive # 4 , Shingle Springs, CA 95682
SIGNED_______________________
NAME(PRINT)___________________________AGE___________
ADDRESS______________________________________________
CITY__________________________STATE_______________
ZIP CODE___________________ Email______________________
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