Marksman M12A User Manual page 19

Parts and Accessories Order Form
Credit Card or Money Order Only
(Sorry No Cash, C.O.D. or personal checks accepted)
Call: (310) 884-7777 Fax: (310) 637-9542
SHIP TO: (No P.O. Boxes)
LAST NAME
STREET ADDRESS
ADDITIONAL ADDRESS
ADDITIONAL ADDRESS
CITY
DAY TIME PHONE NUMBER
CREDIT CARD INFORMATION
CREDIT CARD N0.
CARD HOLDER'S LAST NAME
STREET ADDRESS
CITY
PART #
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
Please give a shipping address where this order may be delivered between the hours of 9 am and 5 pm weekdays.
If UPS is unable to deliver, your order will be returned and additional shipping charges will be required.
DESCRIPTION
California Residents Add Sales Tax = ________ . ______
Shipping and Handling (See Chart) = ________ . ______
On regular orders please allow 4-5 weeks for delivery.
Mail to: Magnadyne Corporation
ATTN: Consumer Parts Sales
P.O. Box 5365
Carson, CA 90749-5365
FIRST NAME
STATE
EXPIRATION DATE
FIRST NAME
STATE ZIP CODE
QTY. PRICE EACH
Sales Subtotal = ________ . ______
TOTAL = ________ . ______
INITIAL
ZIP CODE
VISA
MC
INITIAL
TOTAL
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