Automotive Accessories Connection Order Form

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

Fill out this form below and print it. 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

*Orders over 100.00 shipped free via UPS Ground in the U.S. 48 States

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:

Personal checks and money orders are held for 10 business days before shipment. Credit card payments ship immediate.

Check Money Order Credit Card


Credit card type
Cardholder name
Card number
CCV2 code	3 or 4 digit (see below)
Expiration date
Cardholder Signature

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 Dually
Std. Cab Extended CabCrew 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

Visa, Master Card, Discover And American Express

On Visa, Master Card and Discover the cvv2 code is the last 3 numbers on the back of the card where you sign your name. American Express cvv2 code is a 4 digit number located on the front of the card.

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Automotive Accessories Connection Home Page

Last revised: August 13, 2008

SHIPPING INFORMATION:

METHOD OF PAYMENT:

BILLING ADDRESS ( IF DIFFERENT THAN SHIPPING ADDRESS):

VEHICLE INFORMATION:

THANK YOU FOR YOUR BUSINESS