Professional Air Riveting Tools Order Form
Ordered by: Ship To: (If different than ordered by:)
Name: ________________________________________Name_____________________________________
Address:_______________________________________Address___________________________________
City:____________________St._____Zip____________City:__________________St._____Zip___________
Tel: IMPORTANT_______________________________*FAX_____________________________________
| QTY | Part Number | Description | Unit Price | Total | ||
| Customer
Satisfaction Guaranteed or Money Back
Orders are shipped UPS Ground service, Fully Insured. Note: UPS does not ship to P.O. Box address Add $75.00 for Orders outside of the USA |
Total for Merchandise | |||||
| Sales Tax NY State only 8.25% | ||||||
| Total | ||||||
| Total Enclosed | ||||||
| Charge Your Order Fax to 845-724-5224 24 Hours |
| Payment Method: Visa, Master Card, American Express, Discover | |
| Name of Card Holder | |
| Credit Card Number | |
| Expiration
Date
Credit Card: Billing Address, (Street Only)
|
Please print this form and fax to 845-724-5224
We appreciate your patronage and thank your for your order!
Leave Fax # & *Order Confirmation & Tracking # will be provided.