AFFIDAVIT

Before we can ship to individuals we have to have:

A copy of your driver's license or concealed handgun license
This signed affidavit

X___________________________
Signature

There are no state, local, or federal laws prohibiting me from
purchasing or possessing ammunition, and I am over the age of 21.

NAME______________________ BIRTHDAY____________
ADDRESS___________________
CITY_____________________ STATE________ ZIP________
PHONE___________________
EMAIL____________________
CREDIT CARD______________________ 3-DIGIT SECURITY CODE _____ EXP. DATE_______

VISA , M/C ACCEPTED
TO ORDER CALL 1-800-942-2829
Tennessee Cartridge Company