Order Form

 

L&W Body                                            e-mail: lwsidecar@supernet.com

1711 State Road                                            Internet: www.l-wbody.com

Duncannon, PA  17020                                          Phone: 717-957-3345

                                                                                  Fax:  717-957-4898

Date of Order:  ____________ /____________/__________

Name:  __________________________________________

Address:  ________________________________________

City:  _________________ State:  _______ Zip: _________

*Telephone:  (_______)_____________________________

*(Phone Number must accompany all orders)

E-mail:  __________________________________________

 

Qty.

Description

Price

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Subtotal

 

 

Shipping

 

 

         (Pennsylvania Residents Must Add 6% Sales Tax)    Tax

 

 

Total

 

 

Positively no personal checks will be accepted.  Orders accompanied by personal check will be returned.  Cashier’s check or money order for all shipments