Order or Core Return Form
In order to facilitate the ordering and core deposit return, Please take the time to print and complete this form every to include in all your shipments.  California Residents subject to California Sales Tax

CHROME THAT HOG
911 East 8th Street
National City CA 91950

Name: _____________________________________________
Address: __________________________________________________________________
Telephone #__(____)_________________
Email Address: _____________________________
Identify Method Of Payment: _____________________________________________
Credit cards via www.paypal.com.   Checks or money orders made payable to Chrome That Hog
Year of Vehicle: __________________
Make of Vehicle:___________________________________
Model of Vehicle: ___________________________________________________

NOMENCLATURE	QTY	UNIT PRICE	CORE DEPOSIT	SHIPPING	CREDIT	TOTAL
California Residents TAX 7.75%	******	*********	**************	**************	**********
GRAND TOTAL	******

Thank you for your patronage.  We hope you were satisfied with your savings and our quality plus the overall value.