Howard F. Clark Email howard@mvforge.com

115 35th Place

Runnells, IA 50237

Date Order Taken/Received __________________

Ordered By ________________________

Home Address__________________________

City _______________ State__________ Zip __________

Country__________________

Ship to address (If different from above)

Name________________________

Address_______________________

City_______________ State _____________ Zip _____________

Home Phone _______________ Work Phone___________________

Best time to be called - At home __________ At work _____________

Email Address _________________________

Your Sword

Steel: 1086 or L6

Nagasa (Length from machi to kissaki): ______________

Sori: Depth: ___________ Style: _____________________

Notes (Other specifications for your blade. Howard will try to provide but does not guarantee)

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Deposit________Received ______________

RULES: Deposit is nonrefundable. Once you order is placed it may not be changed. There is no delivery date guaranteed or implied. Balance is due when your blade is finished. A copper habaki is automatically included. Shipping and handling is not included in cost price.

Cost: _________

Less Deposit (_________)

Due when completed..._________