Fax-Back Order Form - Roland's of California

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Fax-Back Order Form

Roland's of California, 8768 9th Street, Rancho Cucamonga, California 91730
Tele: 909-982-2601/909-982-7110 or 800-624-9186 (outside Calif.) Fax: 909-982-8791

Sold To: Name:
Address:
City:	State:	ZIP:

Daytime Telephone:

Ship To: Name:
Address:
City:	State:	ZIP:

Daytime Telephone:

Part No.

Name

Color

Qty

Unit Price

Total Price

	We Welcome Visa & MasterCard
Account No.	____________________________
Expiration Date:	____________________________
Signature:	____________________________

Merch. Total:

Shipping:

Sales Tax:
Calif. residents add 7.75%

Total: