Parts House (1948chevy.com)
Order Form

Name

____________________________________________________________________

Address

____________________________________________________________________

City

____________________________________________________________________

State

____________________

Zip Code

________________________________

Email Address

____________________________________________________________________

Telephone

____________________________________

Item

Part Number

Part Description

Price Ea.

Qty

Total

1

____________

_________________________________

________

_____

__________

2

____________

_________________________________

________

_____

__________

3

____________

_________________________________

________

_____

__________

4

____________

_________________________________

________

_____

__________

5

____________

_________________________________

________

_____

__________

6

____________

_________________________________

________

_____

__________

7

____________

_________________________________

________

_____

__________

8

____________

_________________________________

________

_____

__________

9

____________

_________________________________

________

_____

__________

Subtotal of above totals

__________

California State 8.25% Tax (if applicable)

__________

Shipping & Handling (see Shipping Info)

      6.00       

Total Due (Payable to: Johnny Johnson)

__________


Mail to:    1948Chevy.com      •      P.O. Box 950296      •      Mission Hills, CA 91395