Bragg Exchange Manual Purchase Form

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This is an Example of How Form Should Look.

04/04/2006 1005AM

John Robert Smith III

1234 Sunset Drive Fayetteville, NC 28303

(910) 527-XXXX or (910) 868-XXXX

johnrobertsmith@icloud.com

NC2576458 exp. 12/05/2020  BD 12/05/1959

1. Stove, Kenmore Black and Stainless MN- 101.98765676 SN- 5468796, 1ea 

2. Knife, Gerber MN- 34875 SN- 47689, 3ea

3. Game System, PS3 Sony with 1 controller and cords MN- WRED SN- 6767888, 1ea

$200.00

NOTE: After form is filled out an automated RV should be generated and attach this.