SCOTT'S OLD AUTO RUBBER. ABN: 54 163 105 037
Web Address: www.scottsoldautorubber.com.au E-mail Address: scottsoldautorubber@bigpond.com.au
See below for the various methods of placing your order & payment alternatives.

EASIEST METHOD - PAY BY CREDIT CARD:
COMPLETE ORDERING INFORMATION BELOW.

OR  PAY BY BANK TRANSFER - Your bank must include ALL the information shown in blue.
NEW DETAILS!!! Scott's Old Auto Rubber
12 Haughton Road,
Oakleigh 3166, Melbourne  Australia. 

Bendigo Bank swift code: BENDAU3B 
BSB number: 633-000 Account number: 133352559
Account in the name of: SCOTT'S OLD AUTO RUBBER
Correspondent bank: BENDIGO BANK PINEWOOD BRANCH - Melbourne
Payment by electronic transfer should be in AUD (Australian $) and a standard charge of $2.00 if in AUD for overseas transactions or currency exchange charges of $15.00 AUD may be charged. After making your bank transfer E-MAIL Scott with details.

OR  PAY BY WESTERN UNION MONEY TRANSFER - 
Payment by electronic transfer should be in AUD (Australian $) or currency exchange charges of $15.00 AUD may be charged.
After making your Western Union Transfer E-MAIL Scott with details.   
OR  PAY BY CREDIT CARD. Copy this form from here down to an email or print this form below, charges made in AUD.
Fill in your details & MAIL/FAX the form below with your details to: Within Australia: (03) 956 33023 - International: + 61 - 3 - 95633023
OR  PAY BY CHEQUE OR BANK DRAFT:
Drawn on Australian bank in AUD. Print this form, fill in your details & MAIL the form below with your payment to:

Scott's Old Auto Rubber,  P.O. Box 107, Oakleigh 3166. Australia.

NAME______________________________________________________________________


ADDRESS__________________________________________________________________

 _____________________________________________________POSTCODE (ZIP)______________

 __________________________________COUNTRY_____________________________


Telephone ___________________________________Fax______________________________


E-mail________________________________________

CREDIT CARD PAYMENT: Card Type __________

Name on card __________________________ Expiry Date ___________

Card Verifying Number _  _  _  (last 3 digits on signature strip rear of card - Visa and MasterCard only)
 

CARD   No:  __ __ __ __   __ __ __ __   __ __ __ __   __ __ __ __  or your last invoice number after checking that everything is current 


OR Check enclosed _____________________OR Bank transfer made____________________


DATE________________________ SIGNATURE__________________________________________________________________________________

TYPE OF CAR:___________________________________________________________________________________


Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

Number___ Part  no./description__________________________________________ Price  ea $_________ Total $______

OTHER ITEM_____________________________________________________

Price  $_________________

Postage  $_________________   Registered (Australia)?  $2.00. YES/NO? _______     Insurance? YES/NO?__________

+ GST (Australia only)  $_________________

TOTAL $________________

SEND ALL FAX'S TO: Within Australia: (03) 956 33023 - International: + 61 - 3 - 95633023