ORDER FORM
DE FARMALL CUBS
ORDER FORM
SHIPPING INFORMATION
R
 FIRST NAME
R
 LAST NAME
R
ADDRESS 1
ADDRESS 2
ZIP CODE
R
 CITY
 R
 R
TEL.
R
 EMAIL
R
EMAIL ADDRESS MUST BE CORRECT
PLEASE INCLUDE AREA CODE  
TELEPHONE NUMBER REQUIRED ON
ORDERS PAID WITH CREDIT CARDS
R
R
R
ITEM NUMBER
 QTY
 R
 NAME OF PART
 PRICE
R
SHIPPING METHOD
PLEASE SELECT YOUR SHIPPING PREFERENCE
USPS PRIORITY
 UPS GROUND
BEST WAY - WHATEVER IS LEAST              
            EXPENSIVE FOR PACKAGE WEIGHT
USPS PARCEL POST
PAYMENT
R
INVOICE SENT  BY EMAIL  -  YOU PAY SECURELY  ONLINE USING
YOUR CREDIT CARD.  WE ACCEPT VISA, DISCOVER, MASTERCARD &
AMERICAN EXPRESS. ( PAYPAL ACCOUNT NOT NECESSARY )
PAYPAL-
(DUE WITHIN 10 DAYS)
MONEY ORDER
CALL FOR MY CREDIT CARD INFORMATION*  
TAX EXEMPT - CHECK BOX IF TAX EXEMPT & FORM IS ON FILE WITH US.
I HAVE ORDERED BEFORE, PLEASE USE CARD ON FILE
* BEST TIME FOR US TO CALL
 DAYTIME
 EVENING
 ANYTIME
8:00 - 5:00 PM           AFTER 6:00 PM CST
FEEL FREE TO SEND COMMENTS OR QUESTIONS REGARDING YOUR ORDER
CLICK ONCE
WE ARE NOT ACCEPTING ORDERS OUTSIDE THE UNITED STATES AT THIS TIME.

TO ORDER: WRITE DOWN THE QUANTITY, ITEM NUMBER (FOUND BELOW PICTURE), A
BRIEF DESCRIPTION & PRICE OF THE PARTS YOU WANT & ENTER THEM IN THE FORM
BELOW.  FILL OUT THE SHIPPING & PAYMENT INFORMATION & SUBMIT.  

Once we receive your order, we combine, weigh, calculate your shipping, and send an invoice
if paying with Paypal or by credit card.  

To avoid "undelivered" invoices, please add   teresa@defarmallcubs.com  to your approved
contact email list.  
ITEMS OR SECTIONS MARKED WITH A    R     ARE REQUIRED.

IMPORTANT! DO NOT HIT YOUR "ENTER" BUTTON BEFORE COMPLETING THE
FORM, AS THIS MAY AUTOMATICALLY SUBMIT THE FORM.
PAYMENT BY MONEY
ORDER MUST BE SENT
TO:

DE FARMALL CUBS
2775 LINCOLN ST.
VIDOR, TX 77662
HOLIDAY
ORDERS

ATTENTION
We will be closed
Dec 23rd - 28th for
the Christmas
Holidays
Orders placed during
those days will be
processed on the
29th.
Thank you,

~ Teresa

PRIVACY POLICY

Our customers privacy is
very important to us.

DE FARMALL CUBS does
not rent, sell, or share
personal information
about you with other
people or companies.  
The information you
provide on the order
form is only used to fill
your order.