Porch Electric LLC. Order Form

Tractor Information:

Type:
Model:
Serial #:

Order Information:

Item#

Description

Qty

Customer Information:

Name:
Address Line 1:
Address Line 2:
City:
State:
ZIP:
Phone:
Email:

Payment Information:

If choosing to pay by Paypal, please fill in the following:
Paypal Email
If choosing to pay by Credit Card, please fill in the following:
Name on Card:
Expiration Date:
Number:
CC#:

Please choose a payment type.

Shipping Information:

Shipping Service:

Cost of postage will be added to final total.

Name:
Address Line 1:
Address Line 2:
City:
State:
ZIP:

 

Comments:

 

Email or phone confirmation with total cost will be sent to the customer for approval before money is charged.

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