21
IRONMAN
PARTS REQUEST FAX FORM
Please fax this form to (1-626-810-2166)
OR YOU CAN EMAIL CUSTOMER SERVICE REQUESTS TO
NAME: _____________________________________________________________________
ADDRESS: _________________________________________________________________
CITY ________________ STATE __________________ ZIP ________________
TELEPHONE: (Day) __________________________________________________________
(Night) _________________________________________________________
(Email Address) _________________________________________________
SERIAL#: ______________________________________________________
MODEL#: ______________________________________________________
PURCHASE DATE: ___________________________________________________________
PURCHASE FROM: ___________________________________________________________
“YOUR ORDER WILL BE PROCESSED WITHIN 3 BUSINESS DAYS”
PART #
DESCRIPTION
QTY
OFFICIAL USE ONLY
SHIP DATE: ___________________________________________
TRK #: _______________________________________________
BACK ORDER: ________________________________________
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