Owners manual

Solutions Guide Revision 5
716-759-8666 • [e-mail]
REPLACEMENT
PARTS
ORDER FORM
DATE: __________________________
CUSTOMER # (from receipt): ____________
ORDERED BY:
NAME: _______________________________
COMPANY: ____________________________
S
TREET: ______________________________
CITY: ___________ ST: ____ ZIP: _________
D
AY PHONE: ___________________________
FAX: _________________________________
E-M
AIL: ______________________________
SHIP TO:
N
AME: _______________________________
C
OMPANY: ____________________________
S
TREET: ______________________________
CITY: ___________ ST: ____ ZIP: _________
D
AY PHONE: ___________________________
FAX: _________________________________
E-M
AIL: ______________________________
VEHICLE INFORMATION:
TYPE OF AUTOMOBILE: _________________________
Y
EAR ______ E
NGINE: __ 4
CYL. __ 6 CYL. __ 8 CYL.
TYPE OF DRIVING:
__ STREET __ RACING
__ S
TREET & SLALOM __ S
TREET MODIFIED
Q
UANTITY PART #DESCRIPTION UNIT PRICE AMOUNT
METHOD OF PAYMENT:
__ CHECK/MONEY ORDER __ VISA __ MASTERCARD __ DISCOVER __ AMEX
CREDIT CARD #: _____________________________ EXP: _____________
SIGNATURE: ___________________________________________________
Price subject to change without notice. Not responsible for typographical errors.
NOTE: Name, address & telephone number must be printed on checks. Driver’s License number
required for personal checks.
Total Merchandise
NY Residents Sales Tax
Ins. (add $0.35 per $100.00)
UPS Shipping (please call)
TOTAL
FREE FREIGHT
IF ORDERED WITHIN 30 DAYS OF INITIAL ORDER
MAIL OR FAX YOUR ORDER!
ORDER INFORMATION:
6
Stainless Steel Brakes Corporation
11470 Main Road • Clarence, NY 14031
Ph: 716-759-8666 Fx: 716-759-8688
ssbrakes.com • [e-mail]