04.01.20

PART NUMBER(If listed)

COMPLETE DESCRIPTION(please include brand name)

PAGE NUMBER QTY.

PRICE OF ITEMS

EACH TOTAL

SUBTOTAL

DOMESTIC AND APO/FPO SHIPPING AND HANDLINGBased on order subtotal—see chart at left

DOMESTIC NON-STANDARD SHIPPING CHARGESExample: 2-Day Air, Next Day Air, Oversize—see SummitRacing.com or call us

SALES TAX*See note at left

SUMMIT BUCKS CERTIFICATE OR GIFT CARDSubtract amount; include card or certificate number below –

TOTALWe reserve the right to limit quantities.

Payment by CheckAmount of check is limited to $10,000.00

(U.S. funds only). Checks will be accepted from the United States (including Puerto Rico, U.S. Virgin Islands, and Guam), Canada, Australia, and New Zealand. Name and check number must be imprinted on check. (Phone number and address may be hand written.) Signature must be the same as the name imprinted on the check. TeleCheck will not accept PO Box numbers—it accepts street addresses and route numbers only. Checks must be received within 8 days of check date. Orders will be held 20 days if check is received without this information.+Make checks payable to: Summit Racing Equipment.

Place completed order form in an

envelope and mail to:

Summit Racing EquipmentPO BOX 909

Akron, OH 44309-0909

ORDER ONLINE www.SummitRacing.com

ORDER FAX 1-330-630-5333

ORDER PHONE 1-800-230-3030Four Retail Stores! Visit SummitRacing.com for hours and events.Tallmadge, OH: 1200 Southeast Ave. (I-76 at exit 29) .......................330-630-0250Sparks, NV: 960 E. Glendale Ave. (I-80, exit 19, McCarran to Glendale) ...775-352-8787McDonough, GA: 20 King Mill Rd. (I-75 at exit 216) ..........................770-288-3200Arlington, TX: 2200 E. Interstate 20 ...............................................682-375-2798

Proud member

In-stock parts ordered by 10:00 pm Eastern ship the same day.

Payment by Credit CardWe accept Mastercard, Visa, Discover, AmEx, and Summit

Racing Equipment Synchrony Car Care SpeedCard for all orders. Your credit card will be billed as your items are shipped. If you are mailing in your order, please enter your complete account number, expiration date, and bank name. Make sure to sign the order form! We verify all credit card orders for your protection—in rare cases this process may cause a slight delay in shipping.

** Your credit card will be billed as your items ship from Summit Racing Equipment. Items shipping directly from the manufacturer are billed at time of order.

Using Gift Cards or Summit Bucks

Use your Summit Gift Cards or Summit Bucks over the phone, online, in our retail stores, or for mail-in orders. Just use the certificate number when you place your order. You can spend the entire face value or part of it. The unused balance remains in your account until you place your next order. Summit Bucks must be used by the expiration date.

We reserve the right to limit quantities. THANK YOU!

CARD HOLDER NAME (Please Print)

SIGNATURE

BANK THAT ISSUED CARD:

AMOUNT EXP. DATE

PAYMENT METHOD

CERTIFIED CHECK+

PERSONAL CHECK+

CREDIT CARD**

SUMMIT GIFT CARD

MONEY ORDER

MASTERCARD/VISA/DISCOVER/AMEX ACCOUNT NUMBER

SUMMIT RACING SYNCHRONY CAR CARE SPEEDCARD NUMBER(Apply at SummitRacing.com)

SUMMIT GIFT CARD NUMBER SUMMIT BUCKS CERTIFICATE NUMBER

BILLING/MAILING ADDRESS:Name

Address Apt.

City State Zip

Phone (H) ( ) Phone (W) ( )

E-mail Address

I’d like to receive e-mail news from Summit Racing.

Customer Number

Source Code

Your sales rep’s name

SHIP TO: (if different from Billing/Mailing Address)We cannot ship to a P.O. Box in the contiguous 48 United States.

Name

Address Apt.

City State Zip

Phone (H) ( ) Phone (W) ( )

Please check if this is a business address

Check box if your address has changed or you are a new customer

Mailing address change Using friend’s catalog New customer

SHIPPING & HANDLINGFees are subject to change. For current rates, visit the Help Center at SummitRacing.com.

SUBTOTAL SHIPPING

$0-$98.99 $10.99$99-up FREE

SALES TAX*Summit Racing Equipment collects and remits sales tax based on state and local requirements. If you are unsure of your sales tax requirements, please visit the online Help Center at SummitRacing.com.