Remotes 4 Less Mail or Fax Order Form

If you prefer to order via mail or fax you can print out this form, gather the information for the items you need from our online pages, then complete this order form. 

Remotes 4 Less
13327 Monterey Way
Victorville, CA 92392
Fax: (760) 243-9402
Billing Information      Shipping Information (If Different)
Name  ______________________________________ Name  ______________________________________
Address   ______________________________________ Address   ______________________________________
______________________________________ ______________________________________
City  ______________________________________ City  ______________________________________
State  _________________________ Zip _________ State  _________________________ Zip _________
E-Mail ______________________________________ E-Mail ______________________________________
Phone  _________________  Fax ________________ Phone  _________________  Fax ________________
   

Qty.

Item #

 Description Unit Price Total
            
            
            
            
            
            
            
            

* All orders shipped within California add sales tax @ 8.25% of the subtotal.  
Shipping & Handling- See Chart  

Subtotal

  

Sales Tax *

  

Shipping 

  

Order Total

  
Shipping & Handling Information Payment Information

Number of Items

Shipping Cost
1-4 $4.95
5-9 $6.95
10-19 $10.95
20-29 $14.95
30-39 $18.95
40-49 $22.95
50-59 $26.95
60-69 $30.95
70-79 $34.95
80-89 $38.95
90-99 $42.95
100+ Cost will be emailed

Check                       Money Order

Visa                          Master Card

Discover Card          American Express

Credit Card #  _________________________________

Expiration Date:  Month _____  Year _______

Credit Card Verification Code ___________

(last set of 3 or 4 numbers from back of card)
Name on Card _________________________________
 
Signature ______________________________________
Currently we are only shipping within the USA.
Our shipping charges are based on the total quantity of items ordered and are listed above. All orders are shipped via USPS with delivery confirmation. Once your item is shipped you will be sent an email confirming the shipment and the tracking number of the package.
NOTE: All orders to PR, VI and HI and for orders exceeding 100 items will have additional shipping charges added according to the total weight of the order. We will quote you via email of these additional charges prior to proceeding with your order.