Faxable Order Form

Use this form to place an order by mail or fax. Fill it in on your computer then print it and send it to us:
561-540-1669

Tint Protector
PO Box 3433
Lantana, FL 33465

Fax/Mail Order Form

BILL TO ADDRESS:	SHIP TO ADDRESS IF DIFFERENT FROM BILLING
Name	Name
Company	Company
Address	Address
Apartment/Suite #	Apartment/Suite #
City	City
State	State
Postal Code	Postal Code
Country	Country
Day Time Phone	Day Time Phone
Fax (If Applicable)	Fax (If Applicable)
E-Mail Address	E-Mail Address

Qty	Item	Total $

Subtotal

Shipping

Total

* Shipping charges are based on the total weight of the shipment. 1-2 items is $4.99 2-4 is $7.95 4-unlimited is $11
*We normally ship Priority Mail taking 2-3 days to delivered to you inside the USA.
*All International orders are shipped via US Mail, with charges equaling $15.20 for the first 2 items and $23 for 3-unlimited.

Money Order or Check

Credit or Debit Card

Certified or Personal Check	Visa
Money Order	Mastercard
	Discover/Novus
	American Express

Card Number

Exp. Date

CVV Code

CVV Code