Parts and Accessories Order Form
Credit Card or Money Order Only | Mail to: Magnadyne Corporation | |
(Sorry No Cash, C.O.D. or personal checks accepted) | ATTN: Consumer Parts Sales | |
P.O. Box 5365 | ||
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| Carson, CA |
SHIP TO: (No P.O. Boxes) |
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LAST NAME |
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| FIRST NAME |
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| INITIAL | ||||||||||||||
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STREET ADDRESS |
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ADDITIONAL ADDRESS |
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ADDITIONAL ADDRESS |
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CITY |
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| ZIP CODE | |||||||||||||||
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DAY TIME PHONE NUMBER |
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| CREDIT CARD INFORMATION |
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| VISA | ||||||||
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| MC | ||
| CREDIT CARD N0. |
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| EXPIRATION DATE | |||||||||||||||||
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| CARD HOLDER’S LAST NAME |
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| FIRST NAME |
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| INITIAL | |||||||||||||
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| STREET ADDRESS |
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CITY
PART #
| STATE | ZIP CODE |
|
DESCRIPTION | QTY. | PRICE EACH | TOTAL |
Shipping and Handling
Up to $20.00 | $5.00 |
20.01 to 30.00 | 5.95 |
30.01 to 45.00 | 6.50 |
45.01 to 70.00 | 6.95 |
Over 70.01 | 7.95 |
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Sales Subtotal = ________ . ______
California Residents Add Sales Tax = ________ . ______
Shipping and Handling (See Chart) = ________ . ______
TOTAL = ________ . ______
On regular orders please allow
Please give a shipping address where this order may be delivered between the hours of 9 a.m. and 5 p.m. weekdays. If UPS is unable to deliver, your order will be returned and additional shipping charges will be required.