Briley MFG 1230 Lumpkin, Houston, TX 77043 1-800-331-5718 SMP@Briley.com E-mail Address: * First, middle and last name REQUIRED Date Attention Other Jacob (Jake) Young Larry Hannah Reed Steve Power Stormy If other Daytime Phone Number Billing Address Return Shipping Address I am sending Briley Complete ShotgunComplete RifleComplete HandgunBarrel OnlyFrame/Receiver OnlyTrigger Group Only Make and Model Serial # List any accessories included Please return gun case, original box, and shipping materials to me NoYes Intructions I am including CheckMoney OrderCredit CardPlease call me for credit card CC Type VisaMastercardAmerican ExpressDiscover Name on card Card # Card Expiration Additional Info./Instructions Where did you first hear about Briley MFG? * Required