Parts Order Form - Browning

Parts Order Form

Date: Your P.O.#

Your Name/Shop Name

SHIPPING ADDRESS

Street

City

State

Zip Code

Phone

Daytime Phone:

Extension:

B I L L I N G A D D R E S S (credit card users only)

Street

City

State

Zip Code

Phone

Fax:

Shipping Instructions:

Shipping Charges:

Payment Method:

UPS Ground $8.00

MasterCard

2nd Day Air $13.50

UPS Overnight $24.50

VISA

Discover

Cash

Standard U.S. Postal Service $8.00

Check

Money Order

Card#

Expires

Name Shown on Card

Model

Serial Number

Signature

Gauge/Caliber

Stock Number

Page No. Product Name & Description Qty Unit Price Total Price

*Sales Tax

Shipping & Handling

* Customers of the following states please add the applicable state sales tax:

Illinois

6.25%

Missouri 7.85%

Total Order

New York 7.25%

Texas

8.25%

Utah

6%

Washington 8.4%

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