ORDER FORM
"R" Motor Sport, Ltd.
7273 Montgomery Lane
Victor, New York 14564
tel. 585-737-3482
ORDER IDENTIFICATION __________________________        DATE __________________

BUYER NAME   __________________________________        SHIPPING INFORMATION

ADDRESS        __________________________________       ________________________

CITY/STATE/ZIP _________________________________       ________________________

HOME PHONE ___________________________________      ________________________

BUSINESS PHONE ________________________________      ________________________

ITEM#                                                  DESCRIPTION                                                       COST
1                                                                                                                                                   
2                                                                                                                                                   
3                                                                                                                                                   
4                                                                                                                                                   
5                                                                                                                                                   
6                                                                                                                                                   
7                                                                                                                                                   
8                                                                                                                                                   
9                                                                                                                                                   
10                                                                                                                                                 

                                                                         TOTAL                                                  

                                                          NYS SALES TAX                                                  

                                                                     SHIPPING                                                  

                                                            LESS DEPOSIT                                                  

                         BALANCE DUE, PRIOR TO SHIPMENT                                                 
TERMS:

PRICES DO NOT INCLUDE TAXES, IF APPLICABLE.
ALL PRICES F.O.B. VICTOR, NEW YORK.
SPECIFICATIONS AND PRICING SUBJECT TO CHANGE WITHOUT PRIOR NOTICE.
LICENSING IS THE RESPONSIBILITY OF THE BUYER.
BUYER AGREES FULL LIABILITY FOR CONSTRUCTION, MAINTENANCE, AND OPERATION OF HIS/HER AUTOMOBILE.
BUYER AGREES TO NOT REPLICATE OR COPY ANY ITEMS INCLUDED IN THE PACKAGE OR OPTIONAL ITEMS.
ALL RETURNS WILL BE SUBJECT TO A 25% RESTOCKING FEE. PRIOR WRITTEN PERMISSION FOR RETURN MUST BE SUBMITTED
TO "R" Motor Sport, Ltd. AND AUTHORIZED BEFORE RETURN OF ITEMS. SHIPMENT OF RETURN GOODS MUST BE PREPAID OR
THEY WILL NOT BE ACCEPTED. NO RETURNS AFTER 90 DAYS.

I HAVE READ THE TERMS APPLICABLE TO THIS ORDER AND AGREE TO SAID TERMS AS STATED.

SIGNED (buyer)
                                                                                                       DATE                                                    

ORDER ACCEPTED BY (seller)
                                                                             DATE