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ADDRESS: ___________________________________________________________________________ APT OR SUITE: ______________ CITY: ___________________________________________________ STATE: _____________________ ZIP CODE: __________________ _____________________________________________________________________________________________________________________________________ PARTS:
COMMENTS: _______________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________ ENGINE TUNER KIT ORDER: Description: _________________________________________________________ QTY ___________ Price (per Kit): $ _________________ ____________________________________________________________________________________________________________________________________ SERVICE ORDER: __________ SUSPENSION REBUILD__________ PORTING __________ MILLING _________ SPLITTING CASES __________ CARB BORING __________ BLUE PRINTING _________ ENGINE REBUILD __________ OTHER COMMENTS: _______________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________ RESTORATION: SPECIAL ORDER ONLY ~ PLEASE CALL WITH DETAILS ___________________________________________________________________________________________________________________________________ U.S RETAIL PRICES ~ We accept PAYPAL, VISA, MASTERCARD and DISCOVER Method of Payment: Please select one: __________________ PayPal __________________ VISA _________________ MasterCard _________________ Discover Credit Card Number: __________________________ Exp. Date (mo/yr): _______________ Security Code (on back of card): ___________
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