Order Blank 2025 Moore’s Lures – 9019 Mid Lake Road – Woodruff, WI 54568 Phone Orders: (715) 356-6834 – Email Orders: mlures@charter.net Name____________________________________________________ Date Received_________________ Address__________________________________________________ Date Shipped __________________ City/State/Zip_____________________________________________ Mail Class_____________________ Telephone No._____________________________________________ Check No._____________________ Email Address_____________________________________________ Excise Tax No. (If applicable)________________________________ __Visa __MC __Disc __Amex Exp. Date_________ V Code_____ Item No. Qty. Size Style Color/ Finish Description Unit Price Total U.S. Shipping $0-$9.99 = $5.00 $10.00-$74.99 = $10.00 $75.00-$149.99 = $13.00 $150.00-$249.99 = $15.00 $250.00 and Over = Free Foreign Shipping Actual postage rates apply Total for Goods 5.5% Sales Tax (WI Residents Only) Sub Total Shipping and Handling Amount This Side Amount From Back Less Excise Tax Amount Enclosed
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