Order Statement
LOSOK Custom Arms
314 Willow Run Ln
Delaware, OH 43015
1-740-363-8437
Date:_____________
Last Name:__________________________ First Name:__________________________
Address:________________________________________________________________
Phone Number:_____________________________Email:_________________________
"I
certify that I am at least 21 years of age, that there are no Federal
State or Local laws that prohibit me from purchasing ammunition. I also
release
LOSOK Custom Arms from all liability related to the use of the
ammunition. I am sure that I have ordered the correct type of
ammunition for my firearm, and I am aware that LOSOK Custom Arms can not take returns on purchased ammunition."
Signed:__________________________________________________
Please print this form, sign and fax, or email to info@losok.com, along with the copy of your valid ID. Call us at 1-740-363-8437 to arrange a fax.
If you have any questions, don't hesitate to call.