Metal Magic - Brass Order Form

I want to order from

*REQUIRED FIELD

Dies needed by:

Company name:

Customer Number:

Customer contact:

Street address:

City:

State:

Country:

Postal Code/ZIP:

Telephone:

Fax:

E-mail:

* VALID E-MAIL ADDRESS REQUIRED

Purchase Order Number:

Specify type of engraving below:

Brass Combo Die :

Quantity: Heat Comp.

Brass Emboss Die:

Quantity: Press Proof ($40 per die.)

Brass Deboss Die:

Quantity: Latex Proof

Brass Flat Stamp Die:

Quantity: Other:

Magic Dupes
(for emboss dies):

Quantity:

Combo Pre-cast Counters:

.015 .030 .047 .060 .125

Emboss Pre-cast Counters:

.015 .030 .047 .060 .125

Registers to Litho:

Yes No

Type of Stock (Substrate):

Sample sent

Include score on emboss die?

Yes No Emboss Deboss Step down

Stamp Design Number on die?

Yes No Design number:

Heidelberg Lip?

Yes No

Special Notching / Window Cut-outs?

Yes No (Please send drawing to indicate locations.)

Mount Type High?
($30 minimum)

Yes No

Shipping method:

Priority AM Economy Ground

Special shipping:

First AM, if available Saturday
Hold for pick up at station address below:

Special instructions:

Place an Order

Online Order - Brass

Brass Combo Die :

Brass Emboss Die:

Brass Deboss Die:

Brass Flat Stamp Die:

Magic Dupes
(for emboss dies):

Combo Pre-cast Counters:

Emboss Pre-cast Counters:

Place an Order

Online Order - Brass

Brass Combo Die :

Brass Emboss Die:

Brass Deboss Die:

Brass Flat Stamp Die:

Magic Dupes (for emboss dies):

Combo Pre-cast Counters:

Emboss Pre-cast Counters:

Magic Dupes
(for emboss dies):