The following document must be printed out on paper,
then signed and dated by the purchaser.
The HUSTLER magazines will not be shipped without proof of age, as described below
and this form being completely filled out and included with your payment.
Purchase Price agreed upon : ___________________
Shipping charges agreed upon : _____________________
Grand total of payment included : _____________________
ONLY CASHIER`S CHECKS OR MONEY ORDERS IN U.S. FUNDS WILL BE ACCEPTED
WE DO NOT ACCEPT PERSONAL CHECKS, CREDIT CARDS, PAYPAL. NO C.O.D.s
Please make your cashiers check or money order payable to: K . E . N .
Mail your payment along with this completed waiver form to:
P.O. Box 465 / Watertown, South Dakota / 57201-0465
NO PURCHASE AGREEMENT WILL BE ACCEPTED FROM AN INDIVIDUAL UNDER 21 YEARS OF AGE
1.) I, the undersigned purchaser agree that I in no way shall use this purchase of these 351 Hustler magazines as to bring claim, prosecution or suit of any kind,
at any time, for any reason against the seller, supplier, shipper and or carrier, creator, manufacturer, advertiser and or distributor.
2.) I, the undersigned certify that I am in no way associated with, employed by, volunteer services for or act in conjunction with or on behalf of
any of the following agencies and or organizations: Local, State or Federal Law Enforcement Agencies. Local, State or Federal Government agencies
and or organizations, including non-law enforcement agencies and or organizations, Motion Picture Association of America, Writers Guild,
NAACP or any activist organization, Union or movement.
3.) I, the undersigned purchaser do fully admit that by the signing of this agreement I am of my own free will entering into a legally binding contract
of agreement not to use this purchase in any way to adversely affect the seller`s, supplier`s, shipper`s and or carrier`s,
creator`s, manufacturer`s, advertiser`s and distributor`s business or person.
4.) I, the undersigned purchaser certify that I am over the age of twentyone (21) years and wish to enter into a legally binding contract.
5.) I, the undersigned purchaser agree that this Purchase Agreement / Waiver shall become effective upon delivery and receipt of the
351 Hustler magazines ordered / purchased and remain effective regardless of the identity of the recipient of the 351 Hustler magazines.
6.) I, the undersigned have included with this waiver a phtocopy of one of the following:
A PHOTO I.D. such as a State Issued Drivers License and or I.D. Card and or a US. Passport
as proof of identification as well as legal age to purchase Adult Oriented material.
NO ABBREVIATIONS PLEASE!
Purchaser`s FULL signature : ____________________________________________
Purchaser PRINT full name : _____________________________________________
Purchaser`s Date of birth : _______________________________________________
Address No P.O. Boxes
: ________________________________________________
City, State, Zip : _______________________________________________________
Date of the signing of this agreement : _____________________________________