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*By signing my name in the box, I authorize STANDARD in ATL to charge my credit/debit card for the amount listed above for the item/s stated above.

1. 1.Fill out this form completely.
   

2. 2.Print this page.
   

3. 3.Sign in the designated box below
   

4. 4.Either Fax back to 404.355.1412 or scan and email to info@standardatl.com
   

5. 5.Billing and Shipping addresses must match