NAME:

ADDRESS:

CITY:STATE:ZIP:

PHONE:VEH YR:

MAKE:BODY STYLE:

METHOD OF PAYMENT:

Cash        Check         Money Order          C.O.D.   

Visa         MasterCard         Discover        American Express   

CREDIT CARD #

Credit Card  Expiration Date:   3-Digit Code:

CARDHOLDER SIGNATURE:

CA Tax 7.975 % (.07975)
UPS/Freight
C.O.D. Charge     ($8.50)

TOTAL:   

     Fax Orders to:                   Mail Orders to:

     (559) 875-1222                 MR. 40'S 'FATSTUFF'

     or 800-33-Mr 40s              12927 E. Ashcroft Ave.

     (1-800-336-7407)             Sanger, CA  93657

   (Fill in Order Sheet, Print, then Mail or Fax Order)

  Technical Assistance, please call (559) 875-1222