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Fax this form to 715-445-5485, or phone us at 715-445-3178 to place your order.
You may also mail your order to the address above if you prefer. Thank you.

Name:                                                                                     Date:                                

Shipping Address:                                                                                                            

City:                                                 State:                Zip:                                                

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Method of Payment: ___Money Order/Cashier’s Check ___Personal Check ___COD ___Visa/MC

Card #: Exp. Date:___/___ Name on Card:

Authorized Signature:

 ALL PRICES SUBJECT TO CHANGE WITHOUT NOTICE

Merchandise Total (all pages)

 

Shipping & Handling (US Orders)

International orders billed actual shipping.

$4.00

If COD payment, please add $6.00

 

Sub-Total

 

Sales Tax (WI residents add 5%)

 

Order Total

 

 

Manta

Color Patterns

Qty

Price

Total

01 Night Black

 

$19.00

 

03 Natural Walleye

 

$19.00

 

05 Wild Sucker

 

$19.00

 

06 Baitfish

 

$19.00

 

09 Orange Tiger

 

$19.00

 

11 Pearl Tiger

 

$19.00

 

12 Firetiger

 

$19.00

 

13 Lac Seul Perch

 

$19.00

 

14 Bullhead

 

$19.00

 

15 Chartreuse Bandit

 

$19.00

 

16 Orange Bandit

 

$19.00

 

17 Chartreuse Tiger

 

$19.00

 

20 Smallmouth Bass

 

$19.00

 

21 Orange Firetiger

 

$19.00

 

22 Crappie

 

$19.00

 

TOTAL

 

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Manta Hang 10 NEW FOR 2003!

Color Patterns

Qty

Price

Total

01 Night Black

 

$22.00

 

03 Natural Walleye

 

$22.00

 

05 Wild Sucker

 

$22.00

 

06 Baitfish

 

$22.00

 

11 Pearl Tiger

 

$22.00

 

12 Firetiger

 

$22.00

 

13 Lac Seul Perch

 

$22.00

 

15 Chartreuse Bandit

 

$22.00

 

16 Orange Bandit

 

$22.00

 

20 Smallmouth Bass

 

$22.00

 

21 Orange Firetiger

 

$22.00

 

22 Crappie

 

$22.00

 

TOTAL

 

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Super-Shallow Manta

Color Patterns

Qty

Price

Total

01 Night Black

 

$19.00

 

05 Wild Sucker

 

$19.00

 

06 Baitfish

 

$19.00

 

11 Pearl Tiger

 

$19.00

 

12 Firetiger

 

$19.00

 

13 Lac Seul Perch

 

$19.00

 

14 Bullhead

 

$19.00

 

15 Chartreuse Bandit

 

$19.00

 

16 Orange Bandit

 

$19.00

 

17 Chartreuse Tiger

 

$19.00

 

19 Flo. Orange Tiger

 

$19.00

 

21 Orange Firetiger

 

$19.00

 

22 Crappie

 

$19.00

 

TOTAL

 

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 Shark 2 Speed Countdown

Color Patterns

Qty

Price

Total

02 Natural Perch

 

$15.00

 

03 Natural Walleye

 

$15.00

 

05 Wild Sucker

 

$15.00

 

06 Baitfish

 

$15.00

 

11 Pearl Tiger

 

$15.00

 

12 Firetiger

 

$15.00

 

13 Lac Seul Perch

 

$15.00

 

23 Glow Perch

 

$15.00

 

24 Glow Cisco

 

$15.00

 

TOTAL

 

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Shark Deep Diver

Color Patterns

Qty

Price

Total

02 Natural Perch

 

$15.00

 

03 Natural Walleye

 

$15.00

 

05 Wild Sucker

 

$15.00

 

06 Baitfish

 

$15.00

 

11 Pearl Tiger

 

$15.00

 

12 Firetiger

 

$15.00

 

13 Lac Seul Perch

 

$15.00

 

23 Glow Perch

 

$15.00

 

24 Glow Cisco

 

$15.00

 

TOTAL

 

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 Hammerhead

Color Patterns

Qty

Price

Total

01 Night Black

 

$17.00

 

02 Natural Perch

 

$17.00

 

03 Natural Walleye

 

$17.00

 

05 Wild Sucker

 

$17.00

 

07 Frog

 

$17.00

 

09 Orange Tiger

 

$17.00

 

17 Chartreuse Tiger

 

$17.00

 

25 Black/Orange tail

 

$17.00

 

26 Black/Chart. tail

 

$17.00

 

 

 

 

 

TOTAL

 

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Guarantee: All merchandise is guaranteed to be free of manufacturing defects. Your satisfaction is assured. This guarantee does not cover used or abused merchandise. RiverRun Tackle Company reserves the right to make inspection and determination of all warrantee claims. Please note: RiverRun Tackle Company, LLC does not assume responsibility for misuse or use of its products by uninformed, unskilled or skilled consumers.

Returns: RiverRun Tackle Company must authorize all returns. Contact RiverRun for authorization numbers and return labels. Our receiving department may refuse unauthorized returns. Return of merchandise shipped as ordered will be subject to a 15% re-stocking charge.