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LIQUOR/WINE FORMS>
(NEW) HIGH GATE GIN #426008-WRHIGT02 $5.00 (Receipt On 1, Write UPC) 12/31/09 LIMIT 1
LIMIT 1
Purchase (1) 1.75 L of High Gate Gin, send in this completed form and the original CRT with price circled. Write UPC in space provided. 12/31/09
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