Maryland Wood Destroying Insect Report MD-1 (revised Nov. 2005) Conforms to Form NPMA-33

Printed in Black Ink only on 1 part bond paper. Back contains Important Consumer Information Regarding the Scope and Limitations of the Inspection.

Size 8-1/2 X 11. 100 Forms per package.

Also available in 3 and 4 parts see product numbers 2573 and 2574.

This form can be imprinted with your company information for an additional fee. Order product number 2571I