USA Parts Supply
Parts Order Form


Please select the catalog you are ordering from:

1949-1970 Cadillacs 
1971-1985 Cadillacs
1941-1975 Full Size Oldsmobiles 
1961-1975 Oldsmobile F85, Cutlass and 442
1949-1972 Full Size Ford  
1961-1975 Pontiac Tempest, LeMans and GTO 

Vehicle information
Year: (required)
Make: (required)
Model: (required)
Body Style (required)
Trans. type (May be required)
Power brakes:
Power Streering:
Air Conditioning:

Your information
Name:
Customer # (if known)
Is this a change of address?
Address:
 
City:
State:
Zip Code:
Country:
Email address: (required)
Phone number:
Additional phone number:
Additional phone number:

Ship to addres: (if different)
Name:
Attn:
Address:
 
City:
Zip Code:
State:
Country:
Daytime phone #:

E
nter the parts you are ordering
Item# Office use Qty Part no. Year Complete Part Description Price each
1
2
3
4
5
6
7
8
9
10
          SUBTOTAL:
          4.5% VA Sales Tax:
(VA shipments only)
          Insurance:
          Shipping Charges:
(see chart below)
          C.O.D. Charge: ($8.75)
          TOTAL:

Special comments:

UPS GROUND SHIPPING
Orders up to $25.00
add $7.99
25.01 to $40.00 add $9.49
40.01 to $60.00 add $10.49
60.01 to $75.00 add $11.49
75.01 to $100.00 add $12.99
100.01 to $150.00 add $15.99
150.01 to $200.00 add $19.99
200.01 to $300.00 add $23.99
300.01 to $400.00 add $27.95
400.01 to $500.00 add $31.95
500.01 to $600.00 add $34.95
600.01 to $800.00 add $37.95
800.01 to $1000.00 add $39.95
Over $1000.00 FREE!
Add $5.00 per oversized item

METHOD OF PAYMENT
Visa
Master Card
American Express
Discover
Account Number:
Exp. date:
Cardholder's name:
   
Check
Money Order
C.O.D.

Date: I have read the Terms & Conditions
How did you find us?



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