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Custom Bullet Maker List

Download or print this form, complete and sign, and mail to Corbin in order to be listed as a custom bullet maker. If you are already listed, you can request changes by e-mail. We will need to confirm any substantial changes with the person signing the original consent form.


  	Listing Consent Form


	By signing and returning this form with the requested information, 

	the custom bullet maker gives Corbin Manufacturing & Supply, Inc., 

	permission to publicly list this information on Corbin's internet web 

	page, to publish the information in Corbin's World Directory of Custom 

	Bullet Makers print edition and digital publications, and to refer

	callers to the telephone, fax, e-mail, street address and any other

	listed information in response to inquiries about custom bullet

	orders. While every effort is made to accurately list the information,

	Corbin Manufacturing & Supply, Inc., and its officers and employees

	are not responsible for any liabilities arising from errors in or 

	omissions from the list. The person giving consent to list agrees to 

	send revised information in writing immediately in the event of changes

	or discontinuation of business. Only the person signing the form can

	authorize future changes. In the event of ownership changes, the

	listing will be changed by permission of the original owner. 

	Agreed, by (authorized signature):



	On this date: __________________________


	For digital listings, the following information is limited to the 

	number of characters in parenthesis, and any longer response will 

	be cut off at the character length indicated:

	FIRM NAME (30):________________________________________________

	STREET OR PO BOX (30):_________________________________________

	CITY (20):_______________________________


	POSTAL CODE (10):______________

	COUNTRY (20):____________________________

	PERSON TO CONTACT (30):________________________________________

	TELEPHONE (10):  (___)___-____

	FAX (10): (___)___-____

	E-MAIL (30): __________________________________________________

	WEB SITE (30):_________________________________________________

	BULLET JACKETS OFFERED? (Yes/No): _____               

	LEAD WIRE OFFERED? (Yes/No): _____

	BULLET DIAMETERS (up to 10, 3 digits each):

 	____  ____  ____  ____  ____  ____  ____  ____  ____  ____

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