Crime Scene Products	www.EvidentCrimeScene.com	Order Form
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1. MAIL To: EVIDENT, Inc. 739 Brooks Mill Road Union Hall, VA 24176-4025

2. FAX to: FAX 1-888-384-3368

3. CALL: Phone 1-800-576-7606

PURCHASE ORDERS ARE ACCEPTED FROM LAW ENFORCEMENT AND APPROVED CUSTOMERS ONLY

WE ACCEPT VISA, MASTERCARD, AMERICAN EXPRESS, OR OTHER PRE-AUTHORIZED PAYMENT

Date:__________________ Bill To Address (all info required): Agency: ________________________ Address: _______________________ _______________________________ City: _________ State: ___ Zip: _____ Contact: ________________________	PO #:___________________ Ship To Address (all info required): Agency: ________________________ Address: _______________________ _______________________________ City: _________ State: ___ Zip: _____ Contact: ________________________
Telephone: _____________________ E-Mail: _________________________	FAX: __________________________

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Card Type: _____	Exp. Date: _____	Card Number: ________________________	Sub Total:	.
CID#: _____		Name on Card: _______________________	Shipping (required): Call for quote	.
		FID # 54-1634534	Total:	.