Hard Tonneau Covers - http://www.hard-tonneau-covers.com

Postal Mail or Fax in your order

Print out this form and either:

1. Fax it to (801) 838-3172

or

2. Postal mail it to:

Hard Tonneau Covers
P.O. Box 6623

Knoxville, TN 37914


Name (as it appears on your credit card)

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Email Address

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Billing Address (where your credit card statements go)

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Shipping Address

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Day-time Phone Number

(_________) _____________________ - ______________________________

 

Product Numbers

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Subtotal

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Tax (if shipped to TN, please add 9.25%)

______________________________________________________________________

Total

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(  ) I am enclosing a check or money order.
(  ) I want to charge this purchase to my Credit Card

Credit Card (check one):

VISA
MasterCard
American Express
Discover

Card Number: ____________________________________________________________

Expiry Date: _____________________________________________________________

Security Code: ___________________________________________________________
What is this?


Signature: _______________________________________________________________

Please be sure to complete ALL fields before you fax or postal mail this form. If you are paying by check or money order, please allow an additional 3-5 days for processing.

TN residents add 9.25% for sales tax.