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SHOTGUN ORDER FORM

Please print and mail with payment, or fax.

DATE: ______________________
NUMBER:___________________

ORDER FROM: SHIP TO:

NAME: _____________________ NAME: _____________________


ADDRESS: _____________________ ADDRESS: _____________________
_____________________ _____________________
PHONE: _____________________ PHONE: _____________________

CUSTOM ORDER FOR: __________________________________________________________

MAKE: _______________________ MODEL: ________________________ GAUGE: ________

BARRELS:
1st Set: Length: ___________ Chamber: __________ Chokes: Rt./U ___________ Lt./O ___________
2nd Set: Length: ___________ Chamber: __________ Chokes: Rt./U ___________ Lt./O ___________

TOP RIB:
Smooth Concave ______ Matted Concave ______ Level Filecut ______ Solid ______ Ventilated ______

ACTION:
Finish: Casecolor ____________________ Coin _________________
Triggers: Double _____________ Single ____________ Single Selective ___________
Safety: Automatic _______________ Non Automatic _____________ Extra Springs & Pins __________
Locks: Detachable _________________ Slotted Screws _____________ Other __________________

STOCK & FOREARM: STOCK DIMENSIONS:


Type of Stock ______________________ Right/Left Hand Shooter ________________
Type of Forearm ____________________ Drop @ Comb _______________________
Type of Stock Finish _________________ Drop @ Heel _______________________
Type of Butt _______________________ Length of Pull ________________________
Type of Checkering __________________ Cast @ Heel _________ @ Toe _________
Wood Upgrade _____________________ Pitch _______________________________
Stock Oval ________________________ Gold Crest __________________________

Desired Weight: _______ Trunk Case: Maker Furnished & Labled ________ Other ______________

ADDITIONAL COMMENTS: ____________________________________________________________


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