Order Form - Custom Ruger 10/22 Complete gun orders must be shipped to a licensed dealer. We must have an original signature copy of the FFL before we can ship any firearm. Customer guns can be returned directly to the customer upon completion of conversion.
Shipping Your Gun	Services ONLY order form	318 949 9884 phone

Customer Information
First Name
Last Name
Organization
Address
Address
City			DEALER INFO (complete gun orders only) FFL is already on file with your company FFL is attatched to this order Will send FFL later
State / Province
ZIP / Postal Code
Country
Email Address
Phone
Fax
Clark Custom Ruger 10/22 Order Form
I would like to order a complete gun Please perform your conversion on my rifle Model Name Please choose one RDCM (Round Blue .920") FLCM (Fluted Blue .920") RDSS (Round SS .920") FLSS (Fluted SS .920") MWCM (Midweight Blue) MWSS (Midweight SS) CALIBER CALIBER 22 Long Rifle Please specify barrel length Barrel Length 21.5" 20" 18.5" 16.25" Other between 16.25 & 21.5 Standard Stock Supplied on Complete Gun Ruger Walnut Sporter (22 Long Rifle) Optional Stocks Clark Laminated Stock (Sporter or Heritage) $ 155.00 COLOR (select one) Black Brown Cayenne Blue Red STYLE (Select One) Heritage Sporter Clark Laminated Stock (Thumbhole) $ 175.00 Color (Select One) Brown Black Style (select one) Thumbhole Silhouette Sporter Thumbhole Hogue Overmold Stock ($ 75) Bell & Carlson ($ 150 - $ 370) STYLE (Select One) Heritage $ 180 Classic Sporter $ 150 Sporter Thumbhole* $ 180 Anschutz* $ 180 Anschutz Thumbhole* $180 Odyssey (2 Way adj.)* $ 320 Odyssey (3 Way adj.)* $ 370 COLOR (Select One) #02 Black + $ 0 #22 Spider Web + $ 50 #08 Realtree Brownleaf + $ 50 #18 Realtree All-Purpose Gray + $ 50 #28 Advantage Camo + $ 50 * Bull barrel only (Will not work with Midweight conversion) More Options Extended Magazine Release $ 15 Power Custom Scope Mount $ 95 Add Sling Studs to Clark Laminate Stock $ 25 Add Sling Studs to Ruger Factory Synthetic Stock $ 45 Drill back of receiver for cleaning rod $ 30 Pillar Bedding $ 150 Upgrade from PLASTIC to METAL Trigger Housing, trigger & mag catch (Conversions Only) $ 30 Thread barrel 1/2 x 28 $ 75 Thread Protector $ 25 Kid 2 Stage Trigger (Default: Red Curved Trigger & Medium Extended Mag Release) Complete Gun or Barreled Action Add $ 325 Conversion on Customer Gun Add $ 350 3 oz./6 oz. 7 oz./14 oz. 8 oz./1 lbs. 12 oz./1.5 lbs. 1 lbs./2 lbs. 1.25 lbs./2.5 lbs. 1.5 lbs./6 oz. 1st/2nd Stage Red, Curved Red, Straight ( +$16.95 ) Black, Curved ( +$16.95 ) Black, Straight ( +$16.95 ) Trigger Black Silver Assembly Color Sportsman (Flat) Extended (Medium) Speed (Long) ( +$20.00 ) Mag Release Lever Additional Comments or Instructions: Please type any Special Instructions and/or comments Here $ 100 Deposit is Required for complete gun orders. Amount $: Method of payment: Select Payment Method VISA MASTER CARD DISCOVER PERSONAL CHECK Please fill in if different from above customer information. VISA, MC or Discover / / / Expires Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / Year 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 Send this completed form with your deposit. Fax to 318-949-9829, or mail to: Clark Custom Guns, Inc. 336 Shootout Lane Princeton, LA 71067

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TERMS

• Conversions only performed on factory Ruger rifle
• No deposit required for work to be performed on customer's gun. $ 100.00 Deposit required when ordering a complete gun.
• Canceled work orders are subject to a $ 25 cancellation fee and customer is responsible for any work already performed and return shipping charges.
• Please do send any factory magazine(s) that will be used with the rifle.
• Once your custom work is completed, a final invoice for the balance will be mailed to the address below.
  
  Failure to pay this invoice or make other arrangements within 60 days of invoice date will result in your firearm being sold for charges due

• Payment may be made by MasterCard, Visa, Discover, Money Order or personal check.
• PERSONAL CHECKS WILL BE HELD 14 DAYS prior to shipping.
• All work order changes will be assessed a charge of $25 per change and may alter estimated completion date.
• All order change requests must be submitted in writing by fax, e-mail or snail mail.
• When shipping firearms, please ship via UPS or FedEx: CCG, 336 Shootout Lane, Princeton, LA 71067.
• Custom work will be scheduled upon receipt of firearm and/or deposit and a signed work order form.
• Due to Federal regulations, customer's firearms must be returned to address from which they were received. If you have a change of address, written notification is required.
• Return shipping for most rifles is $ 25.

I have read, understand, and agree to the above terms and understand that delivery times estimated are strictly approximate and may vary considerably due to factors out of our control. I also understand that specifications are subject to change due to product improvements and parts availability. Having read and understood these terms, I hereby authorize the above custom work to be performed on my gun.



______/_____/_______	_____________________________
Date	Signature