ORDER FORM
Custom 4x4 Fabrication
11825 S.E. 109th, Oklahoma City, OK 73165
http://www.custom4x4fabrication.com		 Fax: (405) 790-0395
Phone: 1-405-799-7599
Email: sales@custom4x4fabrication.com

Ordered by:

Name: ___________________________
Address: _________________________
Address: _________________________
City/State: ________________________
ZIP: _____________________________
Phone: ___________________________
Email: ___________________________
Vehicle Model & Year: _______________

Ship to: (if different than ordered by)

Name: ___________________________
Address: _________________________
Address: _________________________
City/State: ________________________
ZIP: _____________________________

QTY: Item Description: Total Price:
     
     
     
     
     
     
     

Method of Payment:
 
Check or Money Order (payable to Custom 4x4 Fabrication)
 
MasterCard
 
VISA

Account Number: _______________________________
Exp. Date: _____________________________________

Signature: _____________________________________


Subtotal: __________

Sales Tax*: __________

Shipping**: __________

Grand Total: __________

* Sales Tax: 7.78% will be added to orders in the state of Oklahoma.
** Shipping Costs: Appropriate shipping costs will be added. If you would like shipping costs before you order, please email us with your zip code.
- Confirmation of Order: If you have provided us with your email address, we will email you with an order confirmation including the grand total of your order within 48 hours of receipt of your order.
- Delivery Time: All items will usually ship at the same time. In-stock orders will ship 2-3 days after we receive your order. Back-orders will ship in 2-3 weeks.
THANK YOU FOR YOUR ORDER!