Buy Holy Smoke

Buy Holy Smoke

Please fill in the following fields so we may provide you with a quote. This form will simply email your information to us along with the type of service you would like us to perform for your loved one. We will then contact you with a price quote and assist you in finalizing your request.

Please note, the * indicates required fields.

Your Information

First Name: *
Last Name: *
Shipping Address Street 1: *
Shipping Address Street 2:
Shipping City: *
Shipping State: *
Shipping Zip Code: * (5 digits)
Daytime Phone: *
Evening Phone:
Email: *

Decedent's Information

First Name: *
Middle Name:
Last Name: *
Suffix (Sr., Jr., III, etc.):
Nickname:
How Decedent's Name Is To Appear On Label or Nameplate: *

Complete to Order Ammunition for Shotguns

Gauge of Shell Desired:

Complete to Order Rifle/Pistol Ammunition

Please Type in Desired Caliber  (for example: .22, .30-30, .38)

Packaging and Shipping

Ammuntion Carrier: *
Standard ground shipping

Your Comments

Please share any specific requests you may have:

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