HTML Preview Printable Retail Order Form page number 1.
www.lymanproducts.com
102
Method of payment:
Check MO American Express
Credit Card: MasterCard Visa Discover
Account Number on Card:
Expiration Date:
Card Verification # (last set of digits on back of card)
Signature (Required if using credit card)
Item # Item Name/Description (incl. caliber, dia, if appropriate) Qty.
Total
Price Each
TOTAL:
TOTAL AMOUNT
SHIPPING AND
HANDLING CHARGES
SHIPPING & HANDLING CHARGES
Under $10.00 . . . . . . . . . . . . . . . . .add $4.00
$10.01-$50.00 . . . . . . . . . . . . . . . .add $6.00
$50.01-$100.00 . . . . . . . . . . . . . . .add $8.00
$100.01-up . . . . . . . . . . . . . . . . . .add $12.00
Prices for continental U.S. only.
AK, HI, Canada, or Foreign:
Actual charges will apply
NOTE: Media orders subject to
additional shipping charges
Please Keep a Copy of Your Order
For Lyman questions, or to place an order, call toll-free 1-800-22 LYMAN
or fax this form to 860-632-1699.
For Pachmayr, please call 1-800-423-9704
(except foreign customers, who may call 860-632-2020).
Hours: 9:00 a.m. - 4:30 p.m. Eastern time, Monday-Friday.
Orders may also be placed through our website at www.lymanproducts.com
$1 for NRA Round-Up
(optional)
Lyman Products and Pachmayr are now collecting funds for the NRA/ILA National Endowment for the
Protection of the Second Amendment. This program allows you to “Add a Buck” to your order. This do-
nation will be sent once a month to the NRA. To take part, please include part # 0200012 to your order.
These contributions are not tax deductible.
ORDERED BY: (Please print clearly) Customer No.
NAME:
ADDRESS:
ADDRESS:
CITY:
STATE, ZIP:
DAYTIME PHONE (We will call if we have a question about your order):
EMAIL ADDRESS (for shipping confirmation invoices):
CT. RESIDENTS ONLY:
Add 6.35% Sales Tax
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Page
No.
RETAIL ORDER FORM
Lyman Products Corp.
475 Smith Street
Middletown, CT 06457