Texas  True

Fax  Order  Form

Please print this form, complete in pen, and fax to:

903-939-8397

 

 

Name    ___________________________________________

 

Check one:     _____  Home         _____ Business

 

Address      ____________________________________________________

   

City  ________________________      State  ____________    Zip  _______

 

Phone  -  Day   ____________________   Evening  ____________________

 

E-Mail   ____________________________________

 

Ship to Address  (if different)

 

Name   ____________________________________________

 

Address  ______________________________________________________

 

City  ________________________       State  ____________   Zip  _______

 

ORDER:

Stock #  ______   Description  _____________________ Qty ___   Price _______

 

Stock #  ______   Description  _____________________ Qty ___   Price _______

 

Stock #  ______   Description _____________________  Qty ___   Price _______

 

Stock #  ______   Description _____________________  Qty ___   Price _______

 

                                                                                          Sub-total         ________

                                                                                          Shipping*        ________

                                                                                            Handling          ________

                                    (If applicable - Texas residents)  Sales Tax          ________

*  Standard shipping fees.

*  SSFC - call for exact freight quote                                                                                

                                                                              ORDER TOTAL         ________

 

To pay by Visa, Mastercard, or Discover:

 

Name on Card:  _______________________ Signature:   ____________________

 

Credit Card Number:  ______________________________ Exp:    ____________

 

Card Billing Address  ______________________________________________