Thumper Stuff - Printable Order Form

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Shipping Costs					.
Washington residents - sales tax will be added:					.
Total Enclosed:					.
Bike Model & Year
Method of Payment-
____Check ____C.O.D. (must be prearranged: Call (360) 805-0272
____Credit Card Card Type:
Card Number: Exp. Mo/Yr: / Sec.Code:
Comments:
Please ship the above order to: Name: ___________________________ Phone Number: (____)-___________ Address: ___________________________ ___________________________ Email: _________________________ Country: ______________

Mail or FAX (707)248-0726 this form with the approved payment to:
THUMPER STUFF
17461 147th St SE
Suite 11A
Monroe, WA 98272