Printable Order Form For SoloRacer.com

Mail orders to:
Devo Tech, Inc.
c/o SoloRacer.com
3566 State Rd - Ste #4
Cuyahoga Falls OH 44223
330-940-3249
 
 

Ship To: (name and address)
Residence: ______ or Business: ______
Name:_________________________
Address:_______________________
Address:_______________________
City:________________________ State:_____ Zip:_______
Phone:_____________________
E-mail:___________________________ (for order confirmation)

Bill To: (if different than above)
Name:_________________________
Address:_______________________
Address:_______________________
City:________________________ State:_____ Zip:_______
Phone:_____________________

NOTE: The billing information entered above must match your card issuing banks records. If your billing address and shipping address are different, we required you to fax us a photocopy of the front/back of the credit card you are using. We also request you contact your credit card issuer to have this alternate shipping address added to your credit card information.

List of Items:
Item #: Item Name: Qty: Price Each: Total:
________ ______________________ ____ _________ _________
________ ______________________ ____ _________ _________
________ ______________________ ____ _________ _________
________ ______________________ ____ _________ _________
Merchandise Total: $______________
Shipping (see chart here): $______________
In OH Add 6.75% Sales Tax: $______________
TOTAL: $______________

Method of Payment:
_____ Certified Bank Check or Money Order (payable to "Devo Tech, Inc.")
 
_____ Mastercard   _____ Visa   _____ Discover
Credit card #: ____________________________     Exp. Date: ________ (mm/yy)
CVV#: _________   (3 digit number on back of card near signature)
I agree to pay the above total amount according to my card issuer agreement...
Signed: ____________________________   Date: __________