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YOUR INFORMATION

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Card Type:

 

Card Number:

 

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3-Digit Security Code

 

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Gift Certificate Value

 

Gift Certificate From

 

If Mailing To Recipient Directly Please Include Their Name & Address Here.

 

   

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The certificate will be mailed, so please fill out the your address.

   

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The Clipper Inn
126 State Street, Clayton, New York 13624
Call (315) 686-3842

http://www.riversidemediagroup.com

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