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T.A.S. Auto Parts Date:     
 
 
60A Progress Drive · Manchester, CT 06042
tasauto.com · 1-800-819-3109		 Customer Number:   
 
Bill To Ship To
Name:      Name:     
C/O:      C/O:     
Address:      Address:     
City:      City:     
State:    Postal Code:     State:    Postal Code:    
Daytime Phone:      Daytime Phone:     
Email:         
 
Payment Type:   Money Order    Car Info: Year:   
  Check (Please allow extra time for delivery.) Model: 
  Credit Card
Card Number:     
Expiration Date:     
Cardholder's Signature:   
 Foreign orders please include:
Issuing Bank Name:    Exterior color:   
Bank Phone #:    Interior color:   
For your protection, we thoroughly investigate the validity of all credit card orders.
 
Part # Description Unit Price Quantity Line Price
         
         
         
         
         
         
         
         
         
         
         
         
         
         
         
Subtotal:   
Toll Free Order Desk:  1-800-819-3109
Customer Service:  1-860-645-1933
U.S. Toll Free Fax:  1-800-882-5769
International Fax:  1-860-645-1845
In CT Add 6% Sales Tax:   
Shipping:   
If COD, Add:  $10.50 
TOTAL:   
 
Please view the "Terms and Conditions" on the Order Policy page of our Web Site for detailed information on placing your order. Oversize items ship via truck freight and require extra shipping charge. Please call or visit our website to get the actual shipping charge for your order.