ORDER FORM
Print Your Name ______________________________________________
MODEL# DESCRIPTION SIZE PRICE 1QTY. SUB TOTAL
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Shipping and Handling:
$ 00.00 - $ 25.00  Add $3.00
$ 25.00 - $ 50.00  Add $4.00
$ 50.00 - And Up  Add $5.00
Sub Total__________
California Residents Add 8% tax
Tax__________
Please add shipping & handling based on schedule at left
S&H__________
Total:
$__________

Select Payment Type:
 
 __CHECK      __ MONEY ORDER     __ CREDIT CARD

Credit Card Information

MasterCard / Visa (Circle one)  

 Card #:______________________ Exp Date:_______

Full Name on Card:________________________

(Please print):

Name:_____________________________________________________

Address:___________________________________________________

City/State__________________________________________________ Zip________

Phone:(______)___________________ Fax:(______)____________________

Email:_____________________________________

 

Mail this order form (be sure to include both pages) and your check or money order to:

OWNER AMERICAN CORPORATION
3199-B Airport Loop Dr.
Costa Mesa, California, 92626

For Credit Card orders by phone or any questions call (714) 668-9011