Custom Ruger 10/22 Online Order Form

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

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 CALIBER

Please specify barrel length

Standard Stock Supplied on Complete Gun

Ruger Walnut Sporter
(22 Long Rifle OR 17 Mach 2)

Optional Stocks
Clark Laminated Stock (Sporter or Heritage) $ 155.00

Clark Laminated Stock (Thumbhole) $ 175.00

Hogue Overmold Stock ($ 75)
Bell & Carlson ($ 150 - $ 370)

* Bull barrel only (Will not work with Midweight conversion)

More Options
Extended Magazine Release $ 15
Power Custom Scope Mount $ 85
Add Sling Studs to Clark Laminate Stock $ 25
Drill back of receiver for cleaning rod $ 20
Bead Blast Black finish off of receiver $ 50
Pillar Bedding $ 150

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:
Please fill in if different from above
customer information.

VISA, MC or Discover
/ / /
Expires /

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 pistol 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 $ 20.

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

	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