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Purvis
Hattiesburg
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Made in Purvis, MS
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Open Tuesday - Friday 9-5:30
Saturday 9-3pm
Rent to Own Info
Bldg # or Desc
First name
*
Last name
*
Mailing Address
*
City, State, and Zip
*
Delivery Address
*
City, State, and Zip
*
Phone Number:
*
Email
*
Birthday
*
Month
Day
Year
Driver's License Number
*
Do you Rent or Own the property shed will be delivered to?
*
Reference 1 Name
*
Reference 1 Relationship
*
Reference 1 Phone
*
Reference 2 Name
*
Reference 2 Relationship
*
Reference 2 Phone
*
Employer
*
Date Started
Month
Day
Year
Employer Phone
Supervisor Name
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