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Fun Imported Auto and Toys

ORDER FORM

ORDER DESK :
860-871-1990
FAX :
860-875-0601
143 Tunnel Road
Vernon, CT 06066


TO ENSURE PROMPT DELIVERY, PLEASE TYPE OR PRINT CLEARLY

SHIP TO:
BILL TO:
CUSTOMER #:
CREDIT CARD ORDERS ONLY
NAME:
NAME ON CARD:
C/O:
ADDRESS:
ADDRESS:
CITY:
CITY:
STATE and ZIP
STATE and ZIP:
CONTACT PHONE: (_____)
DAY PHONE: (_____)
Trans Type:___AUTO ___4-Spd ___5-Spd
HOME PHONE: (_____)
YEAR/MODEL/ENGINE SIZE:


QTY
PART #
DESCRIPTION
UNIT PRICE
PRICE
      $ $
      $ $
      $ $
      $ $
      $ $
      $ $
      $ $
      $ $
      $ $
      $ $
      $ $
$20 MINIMUM ON ALL CREDIT CARD ORDERS
CARD #:
  Shipping
$
Expitration Date:
Month: _______ Year: _______ If COD
$6.00
Card Holder Signature
  CT Res. add 6%
$
Bank Issuing Card
  Total Due
$


FOR YOUR PROTECTION, WE THOROUGHLY INVESTIGATE THE VALIDITY OF ALL CREDIT CARD ORDERS!
If paying by check please allow extra time for deilvery!