Issue link: http://www.e-digitaleditions.com/i/726123
SUB-TOTAL: TAX: __ TOTAL: __ NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: EMAIL: PHONE: YOUR INFORMATION METHOD OF PAYMENT You may fax this form to (202) 544-8244 or mail to: USCHS, 200 Maryland Ave., NE, Washington, DC 20002-5796 Questions? Call toll-free: (800) 887-9318 ext. 10 For local calls: (202) 543-8919 ext. 10 SHIPPING AND HANDLING $20 00 or less $7.95 $50 01 to $75 00 $18.95 $20 01 to $30 00 $9.95 $75 01 to $100 00 $24.95 $30 01 to $40 00 $12.95 MORE THAN $100 00 $34.95 $40 01 to $50 00 $14.95 PLEASE ADD $25.00 SHIPPING FOR EACH FRAMED PRINT. FOR PACKAGES OVER 25 LBS., ADD $10.00 PER 10 LBS. ITEM NUMBER QUANTITY UNIT PRICE EXTENDED PRICE DOME MARKETPLACE *MD Tax (6.0%) & DOC Tax (5.75%) Enclosed is a Check or Money Order payable to U.S. Capitol Historical Society I am paying by Credit Card (please circle one): VISA MC AMEX DISCOVER CARD # __________________________________ Exp. date:___/___/___ Code: ______ /______ Cardholder Signature (required): ___________________________________ Leaving a Legacy By including USCHS in your bequests, you can instill and foster informed citizenship for generations to come. If you are considering a bequest to USCHS, here is some suggested wording for your attorney: After fulfilling all other specific provisions, I give, devise, bequeath _____% of the remainder [or $_____] to the United States Capitol Historical Society, a District of Columbia charitable corporation [Tax ID #52-0796820] currently having offices at 200 Maryland Ave., NE, Washington, DC 20002. For more information please contact Laura McCulty Stepp, VP, Membership and Development at 202-543-8919 x22. 51 THE CAPITOL DOME MARKETPLACE ORDER FORM