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1. Type/Fill in the form. 2. Print the form below. 3. Send the completed form to:Vanek Custom
|Payment Method:||SHIP TO:|
|Type of card:||Name:|
|Card number: - - -||Street Address:|
|Card expiration date: /||City, State, Zip:|
|Name on credit card:||Phone: - -|
|9% AR Tax|
$8.00 Shipping on all parts add $5.00 for insurance.