LightParts.com - Austin, TX.

LIGHTPARTS ONLINE ORDER FORM

Once you've found all the items for your LightParts Online Order, fill out the form below and submit, its that easy! We'll typically respond within one business day (if not sooner), unless there's a holiday, weekend, or a really good party the night before.

PLEASE NOTE: There is a $20 Minimum Order on parts sales.

Name:	Company or Organization:

Address :	City/State/Zip or Postal Code:

Email Address:	Confirm Email Address:

Phone:	Fax:

Country:

Same As Above

Company:	Name:

Shipping Address :	City/State/Zip or Postal Code:

Contact Phone:

Delivery	Preferred Shipping:

Country:

Please copy and paste your parts request from our online parts lists into the fields below, if you need more space you amy use the additional notes field along with any special requests or questions you may have. Remember, prices and availability change all the time, it is essential that you complete these forms to receive a timely quote and order.

Part - Description - Unit Price (copy/paste from parts table)		QTY

Additional notes, comments, requests or more parts listings:

A valid credit card is required for all orders. You will not be� charged upon submission of this order. A member of our sales staff will contact you to finalize the order before your credit card is billed.

LightParts.com uses GeoTrust 128-bit SSL encryption to protect all of your private information on the internet. If you have any questions or are unsure about security, we offer a printable application that you may fill out and fax to us. Click Here to request a fax.

Name on Credit Card:	Credit Card:

Address associated with card:	City/State/Zip:

Credit Card Number:

Confirmation Number (What is This?)

Expiration Date :

I hereby authorize LightParts Inc. to validate my credit card information and use this information to charge my final and agreed upon amount when my order is complete. I understand that I am not being charged when I click the submit button below and will be contacted by the LightParts sales staff on completion of this order request

	I Agree to the Credit Card terms as listed above

	I do not agree and wish to speak to a salesperson

Your order will not be shipped until you have contacted LightParts with final approval for your order unless specified below.

	I waive the option for final approval. Please ship my order now. I understand that my credit card will be charged the pricing reflected on my order confirmation which may differ from web pricing.

	Final approval is required. Do not ship my order until I have contacted you with approval.


	Check here to receive email sales specials from LightParts

Expected Shipping Date. If your order is not in stock, we'll provide you with an expected shipping date whenever possible. This is the best information we have of when you can expect your order to leave the warehouse. Allow additional time for delivery to your location. Please note: These dates are sometimes only estimates provided to us by our suppliers and may occasionally change.

I have also read the Terms & Conditions set forth by Lightparts and understand its sales, warranty and return policies

	I have read and agree to the Terms & Conditions

	I do not agree and wish to speak to a salesperson