ࡱ>   Root EntryZ O2aCONTENTS "CompObjVSPELLINGXiew adult oriented material of any legal type within the privacy of my home. I agree not to duplicate any materials for commercial purposes. I certify under penalty of perjury that the below information is true and correct to the best of my knowledge and the use of a ficticious name and signature does not abdicate me from the above. ( Please be sure to sign your name) Signature _________________________ Date _________________ Printed Name _____________________________ Age _________ Address __________________________________ Apt# ________ ________________________________________________________ City, State, Zip or Country __________________________________ Mail To: Kandi Cox 9811 W. Charleston Blvd # 2162 Las Vegas, NV 89117 Please Print Above Information Clearly To Reduce Delays. ndise (Describe) Totals I Ideclare that I Iam an adult 18 years of age or older and I Iam lawfully entitlred to receive sexually exp.PHn$`PBn(2"'( ) @S  "  ""  "PS"  "|"  // " " tt(/Times New RomanE  " " " ,,K$KDHP DeskJet 1220C (Copy 1)XC od,,LetterDINU"4$_'CHNKWKS "TEXTTEXTFDPPFDPPFDPCFDPCSTSHSTSHSTSHSTSH2SYIDSYIDPSGP SGP dINK INK hBTEPPLC lBTECPLC FONTFONT<STRSPLC :PRNTWNPR`FRAMFRAMr TITLTITL 6DOP DOP 0!ue and correct to the best of my knowledge and tMerchandise Order Form Video Titles: Price - Postage & Handling ___________________________ $ ________ $ ________ ___________________________ $ ________ $ ________ ___________________________ $ ________ $ ________ ___________________________ $ ________ $ ________ Totals $ ________ $ ________ Other Merchandise (Describe) ___________________________ $ ________ $ ________ ___________________________ $ ________ $ ________ ___________________________ $ ________ $ ________ Totals $ ________ $ ________ I declare that I am an adult 18 years of age or older and I am lawfully entitled to receive sexually explicit materials in the community where I live and through my mailing address. I understand that I am purchasing or requesting materials which are of a sexually oriented nature. I believe this material to be within the community standards of the area in which I live. I authorize KandiCox.com to send materials purchased/requested by me to the address listed below. I have not requested the US Postal Service or any other carrier to protect me against the receipt of sexually oriented materials or advertisements. I am not am agent of the USPO or any other carrier or US government agency or law enforcement agency purchasing/requesting adult materials for the purpose of entrapment of KandiCox.con or it s agents. I have not been solicited by any Federal, State or local law enforcement agency to procure any materials from KandiCox.com for prosecutorial purposes. I feel I am an average American citizen or person with the constitutional right to v$$$$-winspoolHP DeskJet 1220C (Copy 1)LPT1:F"l""d"i"` "``""A."@"l""d"i"` "``"."Merchandise Order Form.wps"v "v v (" s true and correct to the best of my knowledge and the use of a ficticious name and signat Z O2Quill96 Story Group Class9qy2y2y22y22 y22 y2