ORDER FORM FOR TECHNICAL ASPECTS OF INSURANCE CLAIMS INVESTIGATIONS

Name:_______________________________
Address:_____________________________
____________________________________
____________________________________
Phone:_______________________________
Email________________________________



.............Number of copies ___ x $99 ea =___________

..........................Illinois Sales Tax (6.5%) =___________

.................................Shipping @ $7.50 ea = ___________

(Shipping for 3 or more copies @ $5 ea) = ___________

............................................................Total =___________

Make check or money order out to: Roberts Publishing



ROBERTS PUBLISHING
2090 Brush Grove Road
Rochelle, Illinois 61068

Phone: 877-556-3039 Fax: 815-562-9071 Email: ccr@croberts.com


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