Automotive Accessories Connection Inc Order Form

Automotive Accessories Connection Inc.
ThePartsSource.com
5161 WARNER RD.
GARFIELD HTS., OHIO 44125
PHONE TOLL FREE: 888-425-2885
FAX: 216-441-9127
Order information

Fill out this form below to fax or mail your order from our print catalog or online specials.

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QTY	DESCRIPTION------SKU#-----COLOR----SIZE---------------PRICE

Sub-total
Choose a method of shipping
Shipping charge (click for details)
Ohio residents add 7.75%
Total

SHIPPING INFORMATION:

First name
Last name
Middle initial
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
Home Phone
FAX
E-mail

METHOD OF PAYMENT:

Check Money Order Credit Card


Credit card type
Cardholder name
Card number
Expiration date

BILLING ADDRESS ( IF DIFFERENT THAN SHIPPING ADDRESS):

First name
Last name
Middle initial
Street address
Address (cont.)
City
State/Province
Zip/Postal code

VEHICLE INFORMATION:

Enter your vehicle year, make, model and number of doors in the space provided below.

2 Wheel Drive 4 Wheel Drive Rear Factory AC
Enter your vehicle engine size and transmission type in the space provided below.

Pickup Truck Info:

Long Bed Short Bed Step Side Fleet Side
Std. Cab Extended Cab

Just print this form and fax it to; 216-441-9127 or mail it to; Automotive Accessories Connection Inc. / 5161 Warner Rd. / Garfield Hts., Ohio 44125

THANK YOU FOR YOUR BUSINESS

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SHIPPING INFORMATION:

METHOD OF PAYMENT:

BILLING ADDRESS ( IF DIFFERENT THAN SHIPPING ADDRESS):

VEHICLE INFORMATION:

THANK YOU FOR YOUR BUSINESS