Mail along with payment for the products you wish to
purchase to:
Iperformance
8400 Craighill Dr.
St. Louis, MO 63123
USA
Please Print
Mailing Address
Name ______________________________________
Address ____________________________________
___________________________________________
City ________________ State ______ ZIP _________
Country ____________________________________
Phone Number _______________________________
Email Address ______________________________
Vehicle Information
Year _________ Make __________________ Model _____________________
Engine Model or Size ______________________________________________
Transmission (Manual/Auto) ________
Air Conditioning (Yes/No) _________
Part # |
Description
| Qty. | Unit Price |
Total Price | Shipping Cost
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Total for Merchandise ____________________
Missouri Residents Add 7.113% Sales Tax ____________________
Total for Shipping ____________________
Grand Total ____________________
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