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SAMPLE REQUEST FORM

Chemical, Inc.

                      Sample Requests

              Please email all sample requests to:

samples@phoenix-chem.com

    -We will send a standard 4 oz. sample via

Fedex Ground at no charge

                      -If in stock, it will ship in 1 business day

             -Please include your full shipping address,

                  phone number and product application

                     -If you need expedited shipping, please

                  include your Fedex account number