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HAND TRUCKS 'R' US - ORDER FORM

Please SIGN FORM and FAX TO (856) 824-0446

Shipping Information

Address:

City: State:                                                          Zip:

Day Phone: Eve Phone:

Billing Information

Address (if different from shipping address):

City:                                                                     State:                                          Zip:

Day Phone: Eve Phone:

Name as appears on Credit Card:

Card Number # _ _  _ _ - _   _   _   _ - _   _   _   _ - _   _   _   _

Expiration Date _   _ (mm) _   _   _   _ (yyyy)

Order Information

Model	No. Units	Price	Subtotal





		Shipping
		TOTAL:

Sign Here (x)

I verify that I am the cardholder listed on this form. I authorize the above listed payment for the amount specified.
I am in possession of the credit card and any charges that are later denied or returned by the credit card are my responsibility.

Date ____ / ____ / _________

Shipping Information
Address:
City:	State:		Zip:
Day Phone:		Eve Phone:

Billing Information
Address (if different from shipping address):
City:		State:		Zip:
Day Phone:			Eve Phone:
Name as appears on Credit Card:
Card Number #	_ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _
Expiration Date	_ _ (mm) _ _ _ _ (yyyy)
Order Information