Firearm, Ammunition &/or High Capacity Magazines                 Legal Disclaimer Form

First time buyers:  Once we have a copy of the form below, you can place orders with us when ever you would like.  “I have read and agree with the return policy.  I certify that I am at least 21 years of age, and that no Federal, State or Local law prohibits me from purchasing, possessing or being shipped firearms, ammunition, high capacity magazines, or related accessories.  I also agree that Mitchell Supply is authorized to charge my credit card accordingly.”

Credit Card                                            Shipping Address                                         Include copy of Driver's License or

Billing Address                                        (leave blank if same as billing)                        Legal Photo ID

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Last Name                                                Last Name

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First Name                                               First Name

____________________                         _________________________

Street                                                        Street

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City                                                          City

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State                                                         State

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Zip Code                                                  Zip Code

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Phone Number                                         Phone Number

OVisa     OMastercard     ODiscover     OCertified Funds

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Card Number (Optional)                                       Exp. Date

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Signature (Required)                                      Date

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Print Name