Send your order  and payment to: 
K. Silver.
P.O. BOX 269.
Twinsburg, OH. 44087

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BILLING INFORMATION 

First Name:

Last Name:

Address:

City:

State:

Zip:

Country:

E-Mail:


PRODUCT INFORMATION

Description

Quantity

Price

Total

$40.00

$40.00

$40.00

$40.00

** additional items please use a separate sheet of paper

Order Total:

Attention! VHS No Longer Available! ONLY DVD-R Format!
 
IMPORTANT! YOU MUST READ AND SIGN 
THE LEGAL DISCLAIMER 
BELOW TO ORDER ANY VIDEOS FROM HCA PRODUCTIONS.

I hereby certify that I am an adult, age 18 or older, and that I am purchasing adult material for private use in my home. I will not furnish this material to minors. I understand that this material is copyrighted, and may not be redistributed. I further certify that I am not a city, state or federal organization ordering this material with the intention of using such material as evidence for the prosecution or harassment of any individual or organization. I do not believe this material is illegal or obscene by my standards, or by my federal, state, country, city or community laws/standards. I simply enjoy this subject material and wish to view it.

SIGNATURE X_______________________________