
USWings.com Jacket Repair Order Sheet
| Description (i.e., A-2, G-1 & size) |
Cuffs $60.00 |
Waistband $60.00 |
Zipper $60.00 |
Cleaning N/A*** |
Shipping per jacket |
Total per jacket |
| $19.95 in USA* |
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| $19.95 in USA* |
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| Subtotal: | ||||||
| Tax** (Ohio residents add 6.5% sales tax): | ||||||
| Grand Total: | ||||||
| Special Instructions: | ||||||
| Personal Info | |
| Name: | |
| Address: | |
| City, State, Zip: | |
| Phone: | Email: |
| Payment Method (please check one) | ||
| ___Money Order (payable to U.S. Wings) enclosed for: $ | ||
| ___Western Union Quick Pay (read details): $ | ||
| ___MoneyGram (read details): $ | ||
| ___MasterCard | Exp. Date: | Account#: |
| ___Visa | Exp. Date: | Account#: |
| ___American Express | Exp. Date: | Account#: |
| ___Discover | Exp. Date: | Account#: |
| Credit Card CVV Code (required for CC orders): | ||
| Signature (required for Repair orders): | ||
| Warning: it is Interstate and International bank fraud to use a credit card that does not belong to you to make purchases on the web. This will lead to imprisonment, major fines, or both. USWings.com has an Electronic Transaction Tracking System securing the safeguard of any transaction. USWings.com will prosecute violators world-wide. |