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Mail Order Form
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Atlantic Innovations, LLC 

Please print, complete, and return this document attesting to the fact that you are of legal age, to purchase and own items of an adult nature, in accordance with your state and local laws.

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Atlantic Innovations

2 Townsend West, Unit 9
Nashua, NH 03063

I, _________________________ (print name) hereby affirm that I am of legal age, in accordance with my state and local laws, to purchase and own items of an adult nature.  I reside in _________________________ (city) which is located in the state of _____ (state).

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