TOYOTA / LEXUS ORIGINAL PARTS ORDER FORM
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CUSTOMER INFORMATION |
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Name |
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Tel # |
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Address |
Must be same as billing address |
Unit |
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City |
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Zip |
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SHIP BY |
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CARD INFORMATION |
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Card # |
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Expires |
CC Tel # |
Customer service 800 # at back of the card |
Card Type |
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VEHICLE INFORMATION |
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Model |
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YEAR |
VIN # |
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Prod. Date |
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Quantity |
Part Number |
Description |
Unit |
Amount |
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List Price |
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Less: 25% DISCOUNT |
You Save |
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Add: Shipping Charges |
Freight |
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TOTAL CHARGE TO CARD |
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Signature: |
Date: |
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NOTICE: You are responsible for the accuracy of your order. Please double check all Part numbers (supplied by you), to avoid ordering and delivery of wrong parts. Parts Ordered are not returnable. We double check all part numbers before shipment. This is a Special Order covered by our Terms and Conditions.
Thank You