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Service Tax Breakup Invoice

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Service Tax Breakup Invoice document sample

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									    PROMOTIONAL PRODUCTS & SHOP AIDS
                                         To order promotional products, use the order blank on the page 891 and
                                                                 send or fax orders to:
                                       Towsleys/Stens, 1424 Dewey Street, P.O. Box 2140, Manitowoc, WI 54220-2140
                                                         FAX 920-683-7411 • Phone 920-683-7400
                                                                                                  Please allow additional time
                                                                                                    for XXL and XXXL items.


                                                                                                 STS105 BENDABLE MINI
                                              STS100 CLICK STICK PEN                             FLASHLIGHT
                                              Round design, retractable Bic roller ball          Use this bendable flashlight to illuminate
                                              pen. Blue with white imprint.                      small, spark spaces. A useful tool for repair
                                              $.54                                               shops and dealerships while operating on
                                                                                                 equipment with tight spaces.
                                                                                                 $3.00




                                              STS102 NOTEPAD
                                              Lined notepad includes Stens’ contact              STS108 KOOZIE
                                              information and distribution center                Keep your drinks cool in the summer.
                                              locations. 5" W x 8" HT.                           These are great giveaways for open
                                              $.90                                               houses and other events.
                                                                                                 $1.00




                                              STS111 STENS BAG
                                              15" W x 18" HT. White plastic bag with             STS114 COTTON CAP
                                              Stens logo on front.                               Black-White-Royal brushed cotton twill low
                                              $.60                                               profile cap with contrasting curve on visor.
                                                                                                 Adjustable velcro strap.
                                                                                                 $6.95




                                              STS112 STENS MOUSEPAD
                                              8 1/2" W x 7 1/2" HT. Full color fabric
                                              mousepad. Graphics feature design of               STS125 MOSSY OAK®
                                              Stens’ homepage.                                   BREAKUP CAMOUFLAGE CAP
                                              $2.75                                              Cap features Mossy Oak® Breakup
                                                                                                 camouflage pattern and an
                                                                                                 adjustable velcro strap closure.
                                                                                                 $5.99



                                              STS106 ROSEWOOD KNIFE
                                              Rosewood and stainless steel buck knife.
                                              6 1/4" x 1/2" in size when open. Knife is
                                              packaged in nylon pouch with belt loop.            STS118 T-SHIRT
                                              $4.95                                              Red. Fruit of the Loom® 100% cotton,
                                                                                                 tagless T-shirt with Stens logo on front.
                                                                                                 $8.95 (add XXL $2.00, XXXL $3.00)
                                                                                                                                                   Lubricants/tooLs




                                              STS104 LED FLASHLIGHT
                                              4" L x 1 1/4" OD. Mini aluminum LED
                                              flashlight comes with 3 AAA batteries.             STS119 STENS POLO
                                              $4.55                                              Blue. Men’s polo with pocket features
                                                                                                 moisture wicking material.
                                                                                                 $31.95
                                                                                                 (add XXL $2.00, XXXL not available)




®




    T H E PA R T S C O M PA N Y   TM
                                                                                                                                             889
                     PROMOTIONAL PRODUCTS & SHOP AIDS

                                                                                                                                                                                                                                                                                                                                                                      STS13 FLEECE PULLOVER                                                       ®
                                                                                                                                                                                                                                                                                                                                                                                                                                                      Serviced with Genuine

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             Replacement
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         STS115 SERVICE CLING
                                                                                                                                                                                                                                                                                                                                                                      JACKET                                                                                              T H E PA R T S C O M PA N Y   TM
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Parts


                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Place this service cling on your customers’
                                                                                                                                                                                                                                                                                                                                                                      Black pullover crafted in a                                               Service Date:

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         equipment after service. Withstands
                                                                                                                                                                                                                                                                                                                                                                      heavyweight polyester fleece.
                                                                                                                                                                                                                                                                                                                                                                                                                                                Next Service:

                                                                                                                                                                                                                                                                                                                                                                                                                                                Serviced By:
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         temperatures up to 175°. Must be placed
                                                                                                                                                                                                                                                                                                                                                                      Features a 10" zipper, elastic waist and
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         on air filter housing or gas tank of
                                                                                                                                                                                                                                                                                                                                                                                                                                                Hours:


                                                                                                                                                                                                                                                                                                                                                                      cuffs. 2 side-entry lined pockets and set-in
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         equipment.
                                                                                                                                                                                                                                                                                                                                                                      sleeves.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         $.55
                                                                                                                                                                                                                                                                                                                                                                      $23.95 (add XXL $3.00,
                                                                                                                                                                                                                                                                                                                                                                      XXXL $4.00)




                                                                                                                                                                                                                                                                                                                                                                                                                            Stens promo sign1.5.pdf   6/27/08   11:33:47 AM




                                                                                                                                                                                                                                                                                                                                                                      ST121 COUNTERSTOOL                                                     HELPING BUSINESS RUN BETTER™
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         ST123 STENS METAL SIGN
                                                                                                                                                                                                                                                                                                                                                                      Great addition to any dealership or repair
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             ASK FOR                                     26" W x 20" HT. Full color Stens logo
                                                                                                                                                                                                                                                                                                                                                                      shop! Premium quality counterstool is
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         imprint on an aluminum sign. One sided.
                                                                                                                                                                                                                                                                                                                                                                                                                       C



                                                                                                                                                                                                                                                                                                                                                                                                                       M



                                                                                                                                                                                                                                                                                                                                                                                                                       Y




                                                                                                                                                                                                                                                                                                                                                                      constructed from heavy gauge tubular
                                                                                                                                                                                                                                                                                                                                                                                                                      CM



                                                                                                                                                                                                                                                                                                                                                                                                                      MY




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         $18.96 ($3.00 additional freight charge)
                                                                                                                                                                                                                                                                                                                                                                                                                      CY



                                                                                                                                                                                                                                                                                                                                                                                                                      CMY



                                                                                                                                                                                                                                                                                                                                                                                                                       K




                                                                                                                                                                                                                                                                                                                                                                      steel frames with a lustrous chrome plated
                                                                                                                                                                                                                                                                                                                                                                      finish. Commercial grade vinyl covering.                              Genuine Replacement Parts

                                                                                                                                                                                                                                                                                                                                                                      Stool measures 30" to the top of the seat.
                                                                                                                                                                                                                                                                                                                                                                      Made in U.S. Black seat features full color
                                                                                                                                                                                                                                                                                                                                                                      Stens logo.
                                                                                                                                                                                                                                                                                                                                                                      $75.00




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         ST126 TRIMMER TRAP SIGN
                                                                                                                                                                                                                                                                                                                                                                      STS78 STENS APRON                                                                                                                                                                  40" W x 20" HT. This full color sign includes
                                                                                                                                                                                                                                                                                                                                                                      Black. 7 oz. polyester/cotton waist apron
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         information on Trimmer Trap products. A
                                                                                                                                                                                                                                                                                                                                                                      with 3 pockets (while quantities last).
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         retail-friendly display sign for dealerships.
                                                                                                                                                                                                                                                                                                                                                                      $5.25
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         ASK YOUR STENS REP FOR PRICING




                      1        2        3      4      5     6   7      8    9 10     11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
                                                                                                                                                                                  Metric
                                                                                                                                                       27 28 29 30 31 32 33 34 35 36                       37 38 39 40 41 42 43 44 45 46                47 48 49 50 51 52 53 54 55 56                        57 58 59 60            61 62 63 64 65 66
                                                                                                                                                                                                                                                                                                                                                                      ST120 COUNTERMAT
                                                                                                                                                                                                                                                                                                                                                                      26" x 17" countermat with Stens contact
                                                                                                                                                                                                                                                                                                                                                                      information as well as a conversion chart
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         ST127 FRANZEN PACKET
                                                                                                                                                                            CONVERSION CHART
                                                                                                                                                         Inches                         Inches                             Inches
                                                                                                                                           Fractions     Decimals   mm      Fractions   Decimals    mm        Fractions    Decimals   mm
                                                                                                                                                                                                                                                                  Into Metric                           Out of Metric
                                                                                                                                                         .0004      .01     21/64       .328       8.334                   .7087      18.
                                                                                                                                                         .004       .10                 .335       8.5         23/32       .719       18.256        If you         Multiply      To                If you         Multiply    To
                                                                                                                                                         .01        .25     11/32       .344       8.731                   .7283      18.5
                                                                                                                                                                                                                                                    know           by            Get               know           by          Get




                                                                                                                                                                                                                                                                                                                                                                      for fraction to decimals to millimeters. Also
                                                                                                                                           1/64          .0156      .397                .3543      9.          47/64       .734       18.653
                                                                                                                                                         .0197      .50     23/64       .359       9.128                   .7480      19.
                                                                                                                                                         .0295      .75                 .374       9.5         3/4         .750       19.050                         Length                                        Length
                                                                                                                                           1/32          .03125     .794    3/8         .375       9.525       49/64       .7656      19.447
                                                                                                                                                         .0394      1.      25/64       .391       9.922       25/32       .781       19.844        inches          2.54         centimeters       millimeters 0.04           inches
                                                                                                                                                                                                                                                    foot           30            centimeters       centimeters 0.4            inches
                                                                           DIAMETER CHART                                                  3/64          .0469      1.191               .3937      10.                     .7874      20.
                                                                                                                                                                                                                                                    yards           0.91         meters            meters      3.3            feet




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         A welcome kit for owners of the Franzen
                                                                                                                                                         .059       1.5     13/32       .406       10.319      51/64       .797       20.241
                                                                                                                                                                                                                                                    miles           1.6          kilometers        kilometers 0.62            miles
                                        1/8                     3/8                                        7/8                             1/16          .062       1.588               .413       10.5        13/16       .8125      20.638                         Area                                          Area
                                                   1.59mm                            9/16
                                                                                                                                           5/64          .0781      1.984   27/64       .422       10.716                  .8268      21.
                                                                       9.53mm                                                                            .0787      2.                  .4331      11.         53/64       .828       21.034        sq. inches     6.5           sq. centimeters   sq. centimeters 0.16       sq. inches
                                                                                                                                           3/32          .094       2.381   7/16        .438       11.113      27/32       .844       21.431        sq. feet       0.09          sq. meters        sq. meters      1.2        sq. yards
                                                                                            14.288mm
                                        1/16                                                                                                                                                                                                        sq. yards      0.8           sq. meters        sq. kilometers 0.4         sq. miles
                                                                                                                                                         .0984      2.5     29/64       .453       11.509      55/64       .859       21.828




                                                                                                                                                                                                                                                                                                                                                                      into and out of metric measurements.
                                                   4.76mm                                                              22.225mm                                                                                                                     sq. miles      2.6           sq. kilometers    hectares        2.47       acres
                                                                                     5/8                                                   7/64          .109       2.778   15/32       .469       11.906                  .8661      22.
                                                                7/16                                                                                                                                           7/8         .875       22.225        acres          0.4           hectares
                                                                                                                                                         .1181      3.                  .4724      12.
                                                                                                                                           1/8           .125       3.175   31/64       .484       12.303      57/64       .8906      22.622
                                                                                                                                                                                                                                                                 Mass (Weight)                               Mass (Weight)
                                        1/4                            11.11mm                                                                           .1378      3.5                 .492       12.5                    .9055      23.
                                                                                            15.87mm
                                                   6.35mm
                                                                                                                                           9/64          .141       3.572   1/2         .500       12.700      29/32       .9062      23.019        ounces         28            grams             grams          0.035       ounces
                                                                                                               1                                                                                                                                    pounds          0.45         kilograms         kilograms      2.2         pounds




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         chain sharpening machine. Kit includes a
                                                                                                                                           5/32          .156       3.969               .5118      13.         59/64       .922       23.416        short ton       0.9          metric ton        metric tons    1.1         short tons
                                                                                     3/4                                                                 .1575      4.      33/64       .5156      13.097      15/16       .9375      23.813
                                                                1/2                                                                        11/64         .172       4.366   17/32       .531       13.494                  .9449      24.                           Volume                                         Volume
                                        5/16
                                                                                                                                                         .177       4.5     35/64       .547       13.891      61/64       .953       24.209
                                                                                                                                                                                                                                                    fluid ounces     30        milliliters          milliliters       0.03     fluid ounces
                                                   7.94mm              12.7mm               19.05mm                    25.4mm              3/16          .1875      4.763               .5512      14.         31/32       .969       24.606
                                                                                                                                                                                                                                                    cups             0.24     liters               liters            2.1      pints
                                                                                                                                                         .1969      5.      9/16        .563       14.288                  .9843      25.
                                                                                                                                                                                                                                                    pints            0.47     liters               liters            1.06     quarts




                                                                                                                                                                                                                                                                                                                                                                      Includes a ruler in inches and centimeters.
                                                                                                                                           13/64         .203       5.159               .571       14.5       63/64        .9844      25.003
                                                                                                                                                                                                                                                    quarts           0.95     liters               liters            0.26     gallons
                                                                                                                                                         .2165      5.5     37/64       .578       14.684      1           1.000      25.400
                                        HANDY HINT — Help your customers get the right blade                                                                                                                                                        gallons          3.8      liters               cubic meters     35        cubic feet
                                                                                                                                           7/32          .219       5.556               .5906      15.                     1.0236     26.
                                        by teaching them to measure correctly.                                                                                                                                                                      pounds          28.3495   grams                cubic meters      1.3      cubic yards
                                                                                                                                           15/64         .234       5.953   19/32       .594       15.081      1 1/32      1.0312     26.194
                                                                                                                                                                                                                                                    ounces          28.3495   cubic meters
                                        A. Measure the blade diagonally from                                                                                                                                                                        gallons          0.004    cubic meters
                                                                                                                                                         .2362      6.      39/64       .609       15.478      1 1/16      1.062      26.988
                                                                                                                                                                                                                                                    cubic feet       0.03     cubic meters




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         30" W x 25" HT full color Franzen sign,
                                           cutting tip to cutting tip.
                                                                                                                                           1/4           .250       6.350   5/8         .625       15.875                  1.063      27.
                                                                                                                                                                                                                                                    cubic yards      0.76     cubic meters
                                        B. Measure the width at the widest part of the blade.                          B                                 .2599      6.5                 .6299      16.         1 3/32      1.094      27.781
                                                                                                                   C                       17/64         .2656      6.747   41/64       .6406      16.272                  1.1024     28.
                                        C. Measure the center hole.                                                                                      .2756      7.                  .6496      16.5       1 1/8        1.125      28.575                      Temperature                                    Temperature
                                                                                                                                           9/32          .281       7.144   21/32       .656       16.669                  1.1417     29.           Fahrenheit     subtract 32 Celsius             Celsius        multiply by Fahrenheit
                                        D. Measure the center to center distance                       A               D                                                                                       1 5/32      1.156      29.369
                                                                                                                                                         .2953      7.5                 .6693      17.                                                             then multiply                                  9/5ths, then




                                                                                                                                                                                                                                                                                                                                                                      $7.61
                                           between the outer holes.                                                                        19/64         .297       7.541   43/64       .672       17.066                  1.1811     30.                          by 5/9ths                                      add 32
                                                                                                                                           5/16          .312       7.938   11/16       .6875      17.463     1 3/16       1.1875     30.163
                                        E. Refer to our catalog if the OEM blade number                                                                  .315       8.                                         1 7/32      1.219      30.956
                                                                                                                                                                            45/64       .703       17.859
                                           is stamped into the blade.




                                   1                2

                                        FAX 800 222-STEN
                                                                  3              4           5             6               7      8   9   10           11            12

                                                                                                                                                                 800 457-7444
                                                                                                                                                                              13
                                                                                                                                                                              INCHES
                                                                                                                                                                                               14           15            16          17       18         19               20          21          22             23

                                                                                                                                                                                                                                                                                                        www.stens.com
                                                                                                                                                                                                                                                                                                                               24           25          26

                                                                                                                                                                                                                                                                                                                                                                                                                                                      WELCOME TO THE                                                                                     10 1/2" W x 5" HT window cling and access
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   REVOLUTION
                   Counter Mat.indd 1                                                                                                                                                                                                                                                                                                            9/12/07 9:49:37 AM




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         to a press release, radio advertisement
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     Maximize your saw time
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      by keeping your chain sharp.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         script, artwork for newspaper
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Get precisely sharpened chain                                     advertisements and an open house
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          in minutes. Every time.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         postcard.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Exclusively distributed by
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         ASK YOUR STENS REP FOR PRICING
                                                                                                                                                                                                                                                                                                                                                                      ST128 STENS BANNER
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              HELPING BUSINESS RUN BETTER™




                                                                                                                                                                                                                                                                                                                                                                      3' W x 2' HT. One sided banner with full
                                                                                                                                                                                                                               ASK FOR
                                                                                                                                                                                                                                                                                                                                                                      color logo.
                                                                                                                                                                                                                                                                                                                                                                      $27.95

                                                                                G E N U I N E R E P L A C E M E N T PA R T S



                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         CUSTOMIZABLE FLOOR MAT
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Customize a floor mat with your logo or
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         company information. This mat is available
Lubricants/tooLs




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         in 2 sizes and 13 colors. Mats also feature
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         the wording “Stens Parts Sold Here”. For
                                                                                                                                                                                                                                                                                                                                                                      ST122 STENS WINDOW CLING
                                                                                 ®




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         pricing, color availability, ordering and
                                                                                                                                                                                                                                                                                                                                                                      Stens window decal to hang in the front of
                                                                                                                                          T H E PA R T S C O M PA N Y                                                                                                                                                  TM
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         more, log onto www.stens.com/floormat or
                                                                                                                                                                                                                                                                                                                                                                      your dealership.
                                                                       PARTS SOLD HE R E                                                                                                                                                                                                                                                                                                                                                                                                                                                                 contact your sales representative. This is
                                                                                                                                                                                                                                                                                                                                                                      $.25
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         a special order item and must be ordered
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         directly from Stens.




                   890                                                                                                            CLICK STENS.COM                                                                                                                                                                                                                              800-457-7444
      PROMOTIONAL PRODUCTS & SHOP AIDS
                                                                           ORDER                                          FORM
                                                                                         SEND OR FAX ORDERS TO:

                                                                     Towsleys/Stens                                                     FAX: 920-683-7411
                                                                        1424 Dewey Street
                                                                           P.O. Box 2140
                                                                                                                                       PHONE: 920-683-7400
                                                                     Manitowoc, WI 54220-2140

           CUSTOMER & SHIPPING INFORMATION:                                                              SHIP TO ADDRESS AND BILL TO ADDRESS (IF DIFFERENT THAN SHIP TO)

           CUSTOMER NAME                                                                                                       CUSTOMER NAME

           ATTN.                                                                                                               ATTN.
SHIP TO:




                                                                                                                    BILL TO:
           STREET ADDRESS                                                                                                      STREET ADDRESS



           CITY                                                                  STATE        ZIP CODE                         CITY                                                                    STATE       ZIP CODE

           (        )                                                            (       )                                     (       )                                                               (       )
           PHONE NUMBER                                                          FAX                                           PHONE NUMBER                                                            FAX




                                                                                     MERCHANDISE INFORMATION

  ITEM #         DESCRIPTION                SIZE(S)       QTY.       UNIT PRICE     TOTAL PRICE
 _________________________________________________________________________________________________
 _________________________________________________________________________________________________
 _________________________________________________________________________________________________
 _________________________________________________________________________________________________
 _________________________________________________________________________________________________
 _________________________________________________________________________________________________
      SHIPPING AND HANDLING CHARGES                         MERCHANDISE TOTAL
               Merchandise Total                   Shipping & Handling Charge    Freight Charges outside
                                                                                 the Continental U.S. will be                                                 UP-CHARGES
                $0.00 - $49.95                               $8.95               actual freight charges. If                                                                       (XXL-XXXL)
                $50.00 - $99.99                             $10.95               paying by check or money       SORRY, NO C.O.D.
               $100.00 - $224.99                            $13.95
                                                                                 order please call Towsleys       ACCEPTED                                                 FREIGHT
                                                                                 for freight amount.
               $225.00 - $349.99                            $15.95                                                                                                    SALES TAX
                                                                                                                                                      (* CA, CO, IN, FL, GA, KS, MI, MN, PA, WI, WV)
               $350.00 - $500.00                            $16.95
                                                                                 DEALER #                                                                                    TOTAL

FOR RUSH ORDERS PLEASE CALL 920-683-7400                                                                                                                         Allow 3-4 weeks for delivery.


                                                  METHOD OF PAYMENT                                                                                   TERMS & CONDITIONS
                                                                                                                                   CLAIMS ADJUSTMENTS: If your shipment arrives damaged, please notify
      CHECK                                                                                                                        the carrier immediately. Do not return damaged merchandise to Towsleys.

                                                                                                                                   * STATE TAX: CA, CO, IN, FL, GA, KS, MI, MN, PA, WI, WV: Add state sales
      MONEY ORDER                                                                                                                  tax on merchandise and shipping or supply resale or tax-exemption certificate.
                                                                                                                                   Freight is not taxable in CA.

      CREDIT CARD
                                                                                                                                   SHIPPING & HANDLING: Orders will be shipped via standard ground
                                                                                                                                   service. For other shipping arrangements, please call Towsleys before placing
                                       MASTER CARD                              DISCOVER                                           your order.
                                                                                                                                   On shipments for dealers who use purchase orders, Towsleys will prepay
                                                                                                                                   shipping charges then add them to your invoice.
                                       VISA                                     AMERICAN EXPRESS

                                                                                                                                   CANCELLED ORDERS: Customers who cancel orders will be billed for
      Account #:_____________________________                                                                                      charges incurred up to the date of cancellation, as confirmed by Towsleys
                                                                                                                                   Customer Service Department.
                                                                                                                                                                                                                                Lubricants/tooLs




      Expiration Date:_________________________
                                                                                                                                   PURCHASER IS RESPONSIBLE FOR ALL FOREIGN DUTIES AND TAXES.

      Signature:______________________________

PLEASE MAKE CHECKS & MONEY ORDERS PAYABLE TO TOWSLEYS INC.

                                            FOR INFORMATION, PLEASE CALL:
                     TOWSLEYS, INC. phone 920 683-7400 office hours 8:00 a.m.                                                                                   to    5:00 p.m., central time
  ®




               T H E PA R T S C O M PA N Y   TM
                                                                                                                                                                                                                          891

								
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