Alabama Department of Archives and History

MICROFILM DUPLICATION ORDER FORM

 

Name : _______________________________________________________________________

Street Address (required for delivery): _____________________________________________

City: _________________________________________________________________________

State: ________________________________________________________________________

Zip Code: _____________________________________________________________________

Country ______________________________________________________________________

Email address: _________________________________________________________________

Phone Number (required to complete order):________________________________________

 

COPYING CHARGES

The shipping and handling charges for microfilm ordered from ADAH outside the United States do not include taxes, duties or brokerage fee; these fees will be the responsibility of the recipient.

 

Cost per roll

Number of rolls ordered

Amount Due for Microfilm

Order

$40.00

$

 

International Orders add additional $10.00 for each roll

$__________________________

 

If paying by check, please include driver's license number on personal checks. A fee of $30.00 will be assessed for returned checks.

 

Text Box: For Official Use:
Dates:
  Pulled __________________
  QCd ___________________
  Sent to vendor___________  
  Recd from vendor________                                   Refiled______by___________
Order form checked and money received by ADAH staff member__________________________________

 

Send payment to:

Alabama Department of Archives and History

Post Office Box 300100
Montgomery, Alabama 36130-0100
334-242-4363 ext. 254
http://www.archives.alabama.gov


Each order must list each microfilm roll separately and include the location number (M# or S#) for each roll. Please only write the location number once. The M or S number is available from the microfilmed newspapers database at: http://www.archives.alabama.gov/newsmicro/search.cfm, or for probate records at http://www.archives.alabama.gov/localrecords/search.cfm .

Please allow 6 - 8 weeks for your order to be filled.

 

TITLE OF COLLECTION

DATE SPAN

LOCATION NUMBER (M# or S#)

 

1. _____________________________________________________________________________________

 

2. _____________________________________________________________________________________

 

3. _____________________________________________________________________________________

 

order sent

date

rolls received

FOR ADDITIONAL TITLES

 

TITLE OF COLLECTION

DATE SPAN

LOCATION NUMBER (M# or S#)

 

1. _____________________________________________________________________________________

 

2. _____________________________________________________________________________________

 

3. _____________________________________________________________________________________

 

4. _____________________________________________________________________________________

 

5. _____________________________________________________________________________________

 

6. _____________________________________________________________________________________

 

7. _____________________________________________________________________________________

 

8.______________________________________________________________________________________

 

9.______________________________________________________________________________________

 

11. ____________________________________________________________________________________

 

12. ____________________________________________________________________________________

 

13. ____________________________________________________________________________________

 

14. ____________________________________________________________________________________

 

15. ____________________________________________________________________________________

 

16. ____________________________________________________________________________________

 

17. ____________________________________________________________________________________

 

18. ____________________________________________________________________________________

 

19. ____________________________________________________________________________________

 

20. ____________________________________________________________________________________

 

 

 

 

 

 

http://www.archives.alabama.gov/patowrk.html