Indiana Army Surplus Order Form
Today's Date:   / /
First Name   Last Name  
Bill To Address   City   State   Zip  
Ship To Address   City   State   Zip  
Phone Number () - Email  
How did you hear about us?  
Visa Mastercard Discover / / /             Exp /
Check* Money Order
Please make checks payable to : The Supply Depot
Qty
Code
Item Name / Description
Size
Price ea.
Subtotal
2
wdbdup1
Woodland Camo Pants(This is only an example, this line is ignored)
M
24.95
49.90
           
           
           
           
           
           
           
           
           
Sub-Total  
Shipping & Handling  
Tax 7% (IN Only)  
Total  
Order Total Price ($) Shipping Charge.
0.01 - 25.00 $9.95
25.01 - 60.00 $11.95
60.01 - 125.00 $13.95
125.01 - 200.00 $17.95
200.00 and over $21.95
Special Rates Apply for certain Items.
 
Check this box if you would like to receive information from time to time about our special offers or services.
* = Please note: Goods will ship only after checks clear.
Mail Order Form & Payment to: Army Surplus, 3714 West 16th Street, Bedford, INDIANA, 47421