Name Change Packet

Mail in Order Form

Please send check or money order to:

Ultimate Kits

P.O. Box 1926

East Greenwich, RI 02818

Qty ___ Ultimate Name Change Kit ~~$22.95~~ sale $19.95 + $4.95 for shipping/ handling= $24.90

*Rhode Island residents only add $1.60 for sales tax= $26.50

Shipping Information:

Name ______________________________________________

Address ____________________________________________

____________________________________________

City ____________________ State _______ Zip ____________

Daytime phone number__________________ or email ______________

Which state would you like your kit specified for? _________________

Have you gotten married yet? _____Yes _____Not yet

How did you hear about The Ultimate Name Change Packet®?

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Bridal Faire

Friend

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All sales are final. We do not accept returns.

Thank you and congratulations!