KOSCIELSKIS GUNS AND AMMO

2926 CHICAGO AVE. S

MINNEAPOLIS MINNESOTA

55407

1-612-827-3832

Please provide a good ship to address (No P.O. Boxes, or Rural Routes)

ORDER FORM ONLY

NAME_____________________________________

ADDRESS_________________________________

CITY______________________________________

STATE____________________________________

ZIP CODE_________________________________

E-MAIL___________________________________

PHONE___________________________________

HANDGUN UPPER: MAKE:_______________  MODEL_______________

1^ST COLOR_______________________________$ 65.00

HANDGUN LOWER: MAKE:_________________  MODEL_______________SER#________________

1^ST COLOR________________________________$ 65.00

Semi Auto Handgun Upper and Lower One Color. $  105.00

COLOR_________________________________________

Semi Auto Handgun Upper and Lower Two Color. $  105.00

1^STUpper COLOR________________________________

2nd Lower COLOR_______________________________

Tiger Stripe Semi Auto Handgun Upper Slide Two Color Only. $ 95.00

1^ST COLOR________________________________________

2nd COLOR________________________________________

Tiger Stripe Semi Auto Handgun Lower Receiver Two Color Only. $ 95.00

1ST COLOR__________________________

2^ND COLOR___________________________

 Tiger Stripe Semi Auto Handgun Upper Slide and Lower Receiver Two Color $ 175.00

1^ST COLOR_____________________________

2^ND COLOR_____________________________

AR-15 Buttstock, Forend and Grip One Color  $ 105.00

Color__________________________________

AR-15 Buttstock, Forend and Grip "Tiger Stripe" Two Color $ 225.00

1^st Color________________________________

2^nd Color________________________________

PLEASE STRIP YOUR LOWER RECEIVER BEFORE SHIPPING

PLEASE PUT ANY PARTS IN A ZIP LOCK BAG, THAT YOU WISH TO DUAL-COAT.

PLEASE SEND CHECK OR MONEY ORDER ONLY.

IT WILL TAKE ANYWHERE FROM 3 TO 7 WEEKS.