PO Box 268, Pine Island, NY 10969
845-258-3564

Toll Free: 866-316-1667


Mon, Wed, Thurs & Fri 10am-6pm  |Tues, Sat & Sun 10am-5pm|   
 Fax: 845-258-3568


This form can be used to order by phone, fax, or mail.
SOLD TO:
Name:   
Street:  
City:     
State:    Zip:
Phone: 		 SHIP TO:
Name:   
Street:  
City:     
State:    Zip:
Phone: 

Qty. Item Size Price Total
Subtotal
8.25% Tax
(NY Res.)
Shipping
Saddles: Please call for quote on shipping Add. Shipping
Total

Payment Method:
Money Order Check (will be verified with check clearing prior to shipment)



Credit Card Account No.
             Expiration Date


________________________________________
Signature