CREDIT CARD BILLINGADDRESS SHIPPING ADDRESS (if different)
COMPANY __ COMPANY__
NAME _____ NAME ____
ADDRESS __ ADDRESS _____
CITY__ STATE _ ZIP ____ CITY__ STATE _ ZIP ___
DAYTIME TELEPHONE __ EVENING TELEPHONE __
NOTE: ALWAYS GIVE STREET ADDRESS: UPS AND TRUCK LINES CANNOT DELIVER TO POST OFFICE BOXES.
Catalog Order Form
Cars, LLC
205 Pearl Street
Neshanic Station, NJ 08853
*Note: UPS charges extra for residential type delivery ($1.10) as well as an
extended rural area delivery fee ($1.50). These charges are not well defined
by UPS and may affect your order total. We suggest you include these
charges if you are unsure. We will gladly refund your money if not required.
wwwwww..oollddbbuuiicckkppaarrttss..ccoomm
YEAR__ CARB.____
NAME__ TRANS.___
SUPER, ROADMASTER
SERIES____ POWER BRAKES___
40,50,70,4800,ETC.
BODY STYLE___ POWER STEERING_
ENGINE, CU. IN.____ AIR CONDITIONING_____
Telephone Number: 908-369-3666 Fax: 908-369-7595
SUB TOTAL
US Shipping Add 10% ($9.50 Min.)
US Residential Delivery ($1.50/$2.50)*
NJ Addresses Add 7% Sales Tax
TOTAL AMOUNT
QTY NUMBERGROUP NUMBERPART DESCRIPTION PRICE TOTAL PRICEEACH OF ITEMS
Credit Card Information
nn Visa nn Mastercard nn Discover
IMPORTANT: COPY ACCOUNT NUMBER FROM YOUR CREDIT CARD
nnnnnnnn nnnnnnnn nnnnnnnn nnnnnnnn
EXPIRATION DATE MONTHnnnn YEARnnnn CVV2nnnnnn
SIGNATURE_____
NOTE:ADDRESS ABOVE MUST BE EXACTLY AS IT APPEARS ON YOUR STATEMENT
3 Digits on Back