Leight Sales Co., Inc.

Order Form

Print this form, fill in your ordering information,  fax it or mail to:

Leight Sales Co., Inc. 1051 E. Artesia Blvd., Carson CA  90746 - Fax Order 1-310-223-1005

 

 Name __________________________________________ 
Address ________________________________________ 
City ___________________________________________ 
PostCode _______________________________________ 
State ___________________Country __________________ 
Phone __________________________________________

 

Product No.

Item Description

Quantity

Price

Total

 

 

 

$

$

 

 

 

$

$

 

 

 

$

$

 

 

 

$

$

 

 

 

$

$

 

 

 

$

$

 

 

 

$

$

 

Sub Total:

$

METHOD OF PAYMENT

Tax: 

$

 

Shipping:

$

 

 

 

 

TOTAL:

$

 

 

Signature ______________________________________________ Date _______________