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www.michigan.gov/msi Note: Non-Profit Organizations, Private Companies and
Citizens must use a Company/Personal Check for payment.
American Flag Order Form Date:
Bill To:
Company:
Address:
State/Province:
Zip/Postal Code:
Phone:
Fax:
Billing e-mail:
Contact Name:
Authorized Signature:
Ship To:
Company:
Address:
State/Province:
Zip/Postal Code:
Phone:
Fax:
Billing e-mail:
Contact Name:
Product No. Description Quantity Unit Price Amount
3259-3X5 3 X 5, 100% Nylon, Price: $19.95 ea.
3259-4X6 4 X 6, 100% Nylon, Price: $29.95 ea.
3259-5X8 5 X 8, 100% Nylon, Price: $47.95 ea.
3259-6X10 6 X10, 100% Nylon, Price: $65.95 ea.
3259-8X12 8X12, 100% Nylon, Price: $99.95 ea.
10% Discount for 6 or more flags Total Quantity:
Free Shipping!! Sub-total1
10% Discount Sub-total2
6% Sales Tax Grand Total:
Form Instructions: Fill out form, “Save As” to your computer and "EMAIL" to MSI Order Entry at [email protected]. Non-Profit Organizations are "Tax Exempt". Private Companies and Citizens include "Sales Tax". State Agencies use SIGMA-IET or POI to order flags. Please mail Company/Personal Checks to: Michigan State Industries, GVP 5th Floor, 206 E. Michigan Ave, Lansing MI. 48933. Contact MSI Sales Dept. at (517) 335-3771 or MSI Customer Service at (517) 335-2102 for further assistance. Thank-YOU!!
City: City:
