If you prefer using a fax, please print out and complete this form and fax it back to us.
LEGACY MOTORS FAX
818-846-5300

I want to order the following item(s)
*Please fill in all fields. Use different lines for each model.
$

Please charge my credit card for the above Item Total plus shipping charge and sales tax if applicable:
NAME ON CARD:    
CREDIT CARD NO.: Exp. Date:  
TYPE OF CARD: Security code:  
3 or 4 Digit Number on Back of Card
SIGNATURE: Date:
Shipping Address must be Billing Address for non-US orders
Address:  
2nd Line:  
City:   State:  
Po Code   Country:  
SAME AS BILLING
Address:  
2nd Line:  
City:   State:  
Po Code   Country:  
STANDARD SHIPPING (3-7 Days)
3 Day Select
International

Fill out at least one of following fields; if you provide email address, we’ll use to confirm order.
EMAIL ADDRESS:
FAX NUMBER:      
DAYTIME PHONE:   NIGHTTIME PHONE:  

If you feel certain you've got enough Legacy Points, circle the Product Code for product(s) for which you want to redeem your points. You must have at least as many points as are required for each model circled.