ORDER FORM	INSTRUCTIONS: Fax or mail this form. Orders can also be placed by calling us between 8:00 AM and 5:00 PM M-F(PST). When sending in shocks for rebuilding, please enclose this form. Note there is a $10.00 service charge for dis-assembling and inspecting your shocks. This will be applied to rebuilding costs if the shocks are good.
Mail to: M & S Hydraulics 7387 S.E. T.V. Hwy Hillsboro, OR 971230
Or call:  Tel (503)642-1122   FAX (503)649-5964

Ordered by Name ___________________________________ Address ___________________________________   __________________________Apt #____ City, State ___________________________________ Zip, Country ___________________________________ Daytime Phone    ( ______ )______________________ Evening Phone    ( ______ )______________________	Ship to Name ___________________________________ Address ___________________________________   __________________________Apt #____ City, State ___________________________________ Zip, Country ___________________________________ Daytime Phone    ( ______ )______________________ Evening Phone    ( ______ )______________________
Please fill-in "Ship to" if different from "Ordered by" or "Ordered by" is a P.O. Box

Part #	Description	Quantity	Unit Cost	Total Price

Rebuild	Exchange	Core Charge	Quantity	Unit Cost	Total Price
Please specify front, rear, model and year under "Rebuild" or "Exchange"

Method of Payment __VISA __DISCOVER __MASTERCARD __AMEX __CHECK _________________________________ Cardholder Name _________________________________ Card Acct No _________________________________ Expiration Date _________________________________ Signature

Shipping Up to $50.00 $10.00 $50.01 - $100.00 $12.50 $100.01 - $250.00 $17.50 $250.01 - $400.00 $22.50 $400.01 - $600.00 $27.50 Includes: Packaging, Handling & Ins. Orders are shipped via UPS. Rates apply to orders shipped within the US. International rates may vary.

Sub total $    Shipping $    Total $    Thank You