CROW AUTOMOTIVE PRODUCTS

ORDER FORM

P.O. BOX 6294 TORRANCE, CA.   90504

PHONE: (310) 532-5528   FAX:  (310) 868-2703

 

 

 

COMPANY NAME:  ________________________________________________  DATE:  ________________

 

ADDRESS:  ________________________________________________________  P.O. #:  _______________

 

PHONE:  _______________________________________  ORDERED BY:  ___________________________

 

YEAR / MAKE OF VEHICLE:  _______________________________________________________________

 

SALESPERSON:  ____________________________  RESALE #:  ___________________________________

 

 

 

HUB AND WHEEL CENTRIC  ________________

 

Quantity

Thickness

Vehicle Bolt Circle

Wheel Bolt Circle

Center-Bore Hub

Center-Bore Wheel

Outside Diameter

Wheel Stud Size

Unit Price

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

**SHIPPING INSTRUCTIONS**

 

UPS SHIPPING:  REG. GROUND  ______  3-DAY SELECT  ______  2ND DAY AIR  _________

 

NEXT DAY AIR  ______  NEXT DAY AIR (SATURDAY)  ______  FEDERAL EXPRESS  ______

 

WILL CALL  ______  SPECIAL INSTRUCTIONS:  _____________________________________

 

**METHOD OF PAYMENT**

 

VISA  ___________________________________________________  EXP. DATE  ___________

 

MASTERCARD  __________________________________________  EXP. DATE  ___________

 

C.O.D.  ______  NET 30 DAYS  ______  COMPANY CK.  ______  MONEY ORDER  ________

 

UPS AMOUNT:  ____________________  TOTAL:  ____________________