Secure Online Order Form

Please Note: This form is only valid for international orders or for item/s that are not found on our online catalog, such special order items. For items that are listed on our online catalog, please complete the checkout form on the online catalog at www.importeccatalog.com.

Personal Information

First Name, Middle Initial, Last Name ( of card holder)

BILL TO Address:  # , Street, City, State, Zip/P. Code, Country ( of card holder )

SHIP TO Address:  # , Street, City, State, Zip/P. Code, Country  ( If different to the above)

E-mail Address

Phone Number (Daytime)  

Phone Number (Evenings)  

Vehicle Information

Year Make Model

Vin (Vehicle Identification Number) & Eng # (Engine Number) -  If required.

Billing Information

Credit Card :      Visa Card   Master Card American Express Discover Card

Credit Card Number:

Expiration Date:      

Method of Shipping

Special instructions for shipping ( i.e. FedEx #, etc. )

Parts Order  

Quote Number (if available) :

Or list below - part numbers, quantity, description and any other relevant information that will enable us to complete the order; or simply copy and paste the original quote from www.importecparts.com.


    By sending this order, I accept the following Terms and Condition of Sale   Main Page