Handgun unit order page

We are working on adding "Shopping Cart" feature to our website as time from product production and new product design allows.
Till then please fill in the following fields, print this page and forward it with previuosly printed order page(s) to us by any of the following means:

Mail all pages to address below
or
Email to: sales14@22lrconversions.com

Please remember "o/s" means the product is in OUT OF STOCK status. Do NOT order it UNTIL the o/s is removed. The order will be returned.

Order Total	$________	From filled out order page
5% Credit Card Payment Surcharge	$________
Credit Card Billing Total	$________

Type of card (circle one) - Master Card, Visa, Discover, American Express

Credit card number - _________ _________ _________ __________

Expiration date - ____________

Name as it appears on credit card - _________________________________________________

Numeric part of billing address of card __________

Zip code of billing address of card __________

3 digit security code on back of card - ________

I, the undersigned, do agree to accept and abide by the conditions of the one year warrenty

included with the product. Signed ______________________________ Date __________

Jonathan Arthur Ciener, Inc.
8700 Commerce Street Cape Canaveral, FL 32920 321 868-2200 Fax 321 868-2201
Email: sales14@22lrconversions.com