OIL
EASY WRENCHES
c/o John LaRocco
1615 Franklin Street Michigan City, IN 46360
Phone (219) 872-0694 Fax (219) 872-0695
E-Mail sales@oileasy.com
FAX OR MAIL ORDER FORM
NAME______________________________________________________
ADDRESS___________________________________________________
CITY________________________________________________________
STATE, ZIP__________________________________________________
PHONE (
)________________________________________________
CREDIT CARD #______________________________________________
CARD EXP. DATE_____________________________________________
CHECK ONE VISA__________ MASTER CARD________
SIGNATURE_________________________________________________
OPTIONAL E-MAIL ADDRESS*________________________________
ABS or CPA Membership # (required for special discount)_____________
DELIVERY ADDRESS IS TO A HOME_______ BUSINESS_________
TOTAL AMOUNT $_________________
OIL EASY WRENCH + S&H = $46.90
Actual shipping costs + handling for all shipments outside the
contienental United States
Indiana residents add $2.40 state sales tax
BACK TO ORDER INFORMATION
*IF YOU INCLUDE YOUR E-MAIL ADDRESS, WE WILL SEND YOU ORDER COMFORMATION AND
TRACKING NUMBERS VIA EMAIL
Office use only...order date______________
shipping date________________