Please complete and submit this order form using the submit button at the bottom of the form.

You may also phone or e-mail us with your custom leather needs or complete and print this order form and mail or fax it to:
               K. C. Miles Leatherworks
               P.O. Box 266
Home                Kimball, MN 55353
Phone: (320) 398-2708
Fax: (320) 398-2706
E-mail: KCMILESLEATHER@AOL.COM

BILLING AND SHIPPING INFORMATION:

Billing Address:

Name        Date

Address

City       

State         Zip   

 

Shipping Address (if different than above):

Address

City       

State         Zip   

 

Phone (Home)

Phone (Work) 

E-Mail            

HOLSTER:

Holster Model     Gun Make 

Barrel Length      Gun Model

Draw Side  - Right Hand                                 Draw Style - Straight Draw 

                      Left Hand                                                         Cross Draw

Buckskin Lining  - Yes                                    Tooling Pattern -

                                No

Miscellaneous

SECOND HOLSTER:

Holster Model     Gun Make 

Barrel Length      Gun Model

Draw Side  - Right Hand                                 Draw Style - Straight Draw 

                      Left Hand                                                        Cross Draw

Buckskin Lining  - Yes                                    Tooling Pattern -

                                No

Miscellaneous

PISTOL CALIBER CARTRIDGE BELT:

Waist Size       Caliber

Hardware -  Nickel                                          Belt Color - Matching

                     Brass                                                               Two-Tone

Number of Shotshell Loops, if any        Right Side

                                                                               Left Side

Extra Cartridge Loops, if any

Elkskin Lining - Yes 

                            No 

Miscellaneous

SHOTSHELL CARTRIDGE BELT:

Waist Size       Caliber

Hardware -  Nickel                                          Belt Color - Matching

                     Brass                                                               Two-Tone

Number of Extra Shotshell Loops, if any        

Elkskin Lining - Yes 

                            No 

Miscellaneous

RIFLE CALIBER CARTRIDGE BELT:

Waist Size       Caliber

Hardware -  Nickel                                          Belt Color - Matching

                     Brass                                                               Two-Tone

Number of Extra Loops, if any        

Elkskin Lining - Yes 

                            No 

Miscellaneous

SADDLE SCABBARD:

Rifle Make       Rifle Model

Barrel Length

ELKSKIN RIFLE CASE:

Rifle Make       Rifle Model

Barrel Length      Rosette - Yes      No

Overall Length (Muzzleloading Rifles)                                                                                       

Quantity  Description   Unit Price Total
         
         
Shipping and Handling Charges      Total Merchandise   
U.P.S. Ground or U.S. Mail    Shipping and Handling  
Continental United States Only          
$ 75.00 to $ 99.99  $10.00     MN Residents -     
$100.00 to $199.99 $12.00     Add 6.5% Sales Tax  
$200.00 to $349.99 $15.00          
$350.00 to $500.00 $17.00     TOTAL   

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