PRINTABLE PURCHASE ORDER FORM

Please include this information with your order

TO:    
 SALT OF THE EARTH WEIGHTED GEAR - 1031 17th Street, - Henderson, NE   68371

COMPANY:______________________________                        PURCHASE ORDER NUMBER______________

                                                                                                                                        





















NOTES:
                                                                                                                                        
Contact Person:                                                                        PAYMENT:
Name_______________________________                        
 I HERBY CERTIFY THAT THERE IS AN UN OBLIGATED BALANCE IN THIS
                                                                                                                                                                          APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER

Number______________________________



                                                                                                                                                                          ________________________________________________________________________
                                                                                                                                                                                         SIGNATURE
PRINTABLE PURCHASE ORDER FORM

Please include this information with your order

TO:    
 SALT OF THE EARTH WEIGHTED GEAR - 1031 17th Street, - Henderson, NE   68371

COMPANY:______________________________                        PURCHASE ORDER
NUMBER
______________

                                                                                                                                         DATE__________

BILL TO:                                                                               SHIP TO:




















NOTES:
                                                                                                                                      
Contact Person:                                                                        PAYMENT:
Name_______________________________                        
 I HERBY CERTIFY THAT THERE IS AN UN OBLIGATED BALANCE IN THIS
                                                                                                                                                                        APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER

Number______________________________



                                                                                                                                                                        ________________________________________________________________________
                                                                                                                                                                                       SIGNATURE