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Zip State Email Address First Name Last Name Address City Country Phone Fax PLEASE NOTE: All information is held in strict confidence and will not be sold, loaned, given or otherwise transmitted to any other company, web site or individual. This information is for the sole purpose of keeping you advised of developments, promotions and products of Chase-Durer, Ltd.

For inormation contact: :t
Chase Durer, Ltd.
8455 Fountain Av.
Suite 515
West Hollywood,
CA 90069

TOLL FREE CALL
1-800-544-4365

Tel: (310) 550-7280
Fax: (310) 550-0830