Parts / Accessories Online Order Form

Parts / Accessories Order Form
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Customer Information

1. Full Name

2. Organization / Company

3. Address

4. Address

5. City

6. State

7. Zip Code

8. Email

9. Phone

10. Fax

Is this your first order? Yes No Back Order OK? Yes No

Quantity

Item
Number

Description

Price
Each

Total

Subtotal

SALES TAX - Louisiana Residents Only ...

Add 4%

Shipping

+ $ 5.00 FedEx residential deliveries

Total

Credit card billing address:
(if different than ship to)

Method of payment:
Card Number - - -
Expires /

Additional Comments or Instructions:
Special Instructions / Comments
Complete form, Print, then mail, Fax 318-949-9829
or Order toll free @ 888-458-4126 M-F 8 am - 4 pm CST
NOTE: Minimum Order $ 20 (excluding shipping)
Clark Custom Guns, Inc.
336 Shootout Lane
Princeton, LA 71067 USA

Customer Information
1. Full Name
2. Organization / Company
3. Address
4. Address
5. City
6. State
7. Zip Code
8. Email
9. Phone
10. Fax
Is this your first order? Yes No		Back Order OK? Yes No

Quantity	Item Number	Description	Price Each	Total






			Subtotal
		SALES TAX - Louisiana Residents Only ...	Add 4%
			Shipping
		+ $ 5.00 FedEx residential deliveries
			Total


	Credit card billing address: (if different than ship to)
Method of payment: Card Number - - - Expires /