-------------------------------  INSPECTION FORM  ----------------------------------
(Circle): Penthouse  Playboy  Hustler  Playgirl  Oui  Screw  Slank   Player  Genesis
Gallery  Velvet  Club-International  Leg  Show  Gent   Confidential  Hot-Talk

    Other Magazine Titles     |  Short Description, if necessary
______________________________|_________________________________________________________
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                              |
                              |
                              |
                              |
                              |
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                              |
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Store Name:  ________________________________________________ (continue on other
                                                                side if needed)
Location:  ___________________________________________________

City: _______________________  Phone Number: ____________________

Manager's Name: _____________________________________________

When Completed Mail to: P.O. Box 8240, Biloxi, MS 39535
__________________________________________________________________________________


-- cut here ---

-------------------------------  INSPECTION FORM  ----------------------------------
(Circle): Penthouse  Playboy  Hustler  Playgirl  Oui  Screw  Slank   Player  Genesis
Gallery  Velvet  Club-International  Leg  Show  Gent   Confidential  Hot-Talk

    Other Magazine Titles     |  Short Description, if necessary
______________________________|_________________________________________________________
                              |
                              |
                              |
                              |
                              |
                              |
                              |
                              |
                              |
                              |
                              |
                              |

Store Name:  ________________________________________________ (continue on other
                                                                side if needed)
Location:  ___________________________________________________

City: _______________________  Phone Number: ____________________

Manager's Name: _____________________________________________

When Completed Mail to: P.O. Box 8240, Biloxi, MS 39535
__________________________________________________________________________________

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