HANCY MFG. COMPANY                                                                                                                                                                                                                                

 

Print this page, fill out this form and mail it with your payment to

Hancy Mfg. Co. 5324 Pheasant Lane, Montague, CA 96064 or fax to (530) 459-0528 Please make checks payable to Hancy Mfg.Thank You!

Ship Order to: (please print clearly)

Name___________________________________________

Address__________________________________________

City____________________St______Zip_______________

Telephone (optional) _________________________ (used to give updates of order status)

e-mail (optional)_____________________________________ (used to give updates of order status)

Product # Item Quantity Price Extension
         
         
         
         
         
         
         
         
         
         

All orders are carefully and quickly packed at our distribution center to assure a prompt and timely delivery.

Subtotal  
CA sales Tax (.0775) (California residents only)  
Shipping $4.60
Total  

                                             Please make checks payable to Hancy Mfg.