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EVIDENTIAL BREATH  ALCOHOL DEVICE ORDER FORM:

Please complete this Order Form with the details about the device(s) you wish to order.
Important: Provide a telephone number where you may be reached — We will call you shortly for payment. You may pay by credit card or eCheck. All devices must be paid in full before shipping. Thank you.


    Jupiter EBTMercury EBTMark V EBTPhoenix 6.0 EBTEV30 EBTUndecided


    YesNo

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