Asian Auto Parts of
Arizona
1701 S. 177th Avenue
Goodyear, AZ 85338
Date ____________________
Name_________________________________________________
Address______________________________________________________________________________
City_____________________________________
State__________________ Zip__________________
Shipping Address (if
Different)_______________________________________________________________________
City_____________________________________
State__________________ Zip__________________
Phone:
Day____________________________________Evening_________________________________
Credit Card Number
________________________________________ Expiration
Date______________
Signature_________________________________________________
Name (as it appears on credit
card)_________________________________________________________
Email Address for order
confirmation_______________________________________________________
Sales Tax (AZ residents only) _________
Order Total $___________
Arizona Residents must add 7% Local Sales Tax
Special Shipping Instructions
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