Reference# 10-22
Shafer Services
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Telephone:  
First Name:  
Last Name:  
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Questions?? CONTACT US AT 847-669-3175
CREDIT CARD INFORMATION
Name as it appears on the credit card:  
Credit Card Number:  
Expiration Date:   Month:      Year:      CSC:
 


SKU DESCRIPTION QUANTITY PRICE TOTAL
         
         
         
         
         
Shipping: $8.95
   
Customers outside the continental U.S. add $26.95 (US) for shipping:  
Illinois residents add 7.00% sales tax.  
(Make checks payable to: HASYOUR FILTERS INC.) GRANDTOTAL:  


Mail your order to:
HASYOURFILTERS
2938 State Route 752
Ashville, OH 43103		 FAX THIS FORM TO
847-669-3594