Take-Back™ Call Tag Order Form QTY PRICE TOTAL I would like to order a Take-Back™ call tag (Each package requires its own call tag) $50.00 Height Width Depth Weight Package Specifications For each package, any combination of length, width and height is acceptable as long as the length plus girth (entire distance around package, or double the sum of the height and width) does not exceed 108" (270 cm). The maximum weight allowed is 30 pounds. Contact Company Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington Washington DC Wisconsin West Virginia Wyoming -------------------- Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Zip Telephone Fax Payment Visa     MasterCard Card Number Expiration Date Code * All fields are required TAKE-BACK™ INITIATIVE Overview Take-Back™ Credo Product Life Cycle Process Order Form © 2008 HARTMANN & FORBES, INC. ALL RIGHTS RESERVED. N E W S L E T T E R | C O N T A C T U S | B R O C H U R E S E A R C H