You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
Fax order form to: 336-227-9871<br />
Please mail order form to:<br />
HUBBARD’S IMPALA PARTS<br />
1676 ANTHONY RD.<br />
BURLINGTON, NC 27215<br />
Name (Print)<br />
Address<br />
City State Zip Code<br />
Telephone #: Day<br />
Night<br />
OVER 7000 PARTS ONLINE AT: www.impalaparts.com SALES/CUST. SUPPORT: 1-800-846-7252<br />
> NO ORDERS WILL BE PROCESSED WITHOUT A VALID DAYTIME TELEPHONE NUMBER <<br />
Part # Item Description Qty Price Total<br />
TRUCK SHIPMENTS<br />
We will be submitting each order for a shipping rate quote<br />
directly to the carrier. This charge will be applied to the order<br />
at the time of purchase, whether online or via telephone.<br />
Please refer to our online Terms & Conditions for the most<br />
current information related to shipping calculations.<br />
https://www.impalaparts.com/Conditions.php<br />
SUB-TOTAL $<br />
6.75% SALES TAX (NC only) $<br />
Call for shipping quote<br />
TOTAL $<br />
CHARGE MY: o VISA o MASTER CARD o DISCOVER o AMERICAN EXPRESS<br />
MINIMUM $25.00 PER ORDER ON CHARGE CARDS.<br />
Please enter all numbers, expiration date, and name as it appears on charge card.<br />
Card holders current billing address (where you receive your statement) must be present.<br />
PLEASE SELECT A<br />
YEAR & BODY<br />
STYLE FROM<br />
THE LIST BELOW<br />
Year<br />
Interior Color<br />
Exterior Color<br />
2 DR HT IMPALA<br />
2 DR HT IMPALA SS<br />
2 DR HT BEL-AIR<br />
2 DR HT CAPRICE<br />
2 DR HT CUSTOM<br />
2 DR CONV. IMPALA<br />
2 DR CONV. IMPALA SS<br />
2 DR SEDAN IMPALA<br />
2 DR SEDAN BEL-AIR<br />
2 DR SEDAN BISCAYNE<br />
4 DR HT IMPALA<br />
4 DR HT CAPRICE<br />
4 DR SEDAN IMPALA<br />
4 DR SEDAN BEL-AIR<br />
4 DR SEDAN BISCAYNE<br />
4 DR WAGON IMPALA<br />
4 DR WAGON BEL-AIR<br />
4 DR WAGON BISCAYNE<br />
NOT LISTED (Write below)<br />
ORDER FORM<br />
Card Number:<br />
Exp. Date:<br />
Card owners signature must be signed<br />
Billing address of credit card<br />
1-800-8-IMPALA • www.impalaparts.com<br />
131