Goto TimcoUSA Home Page Order Form 
Please complete this form, submit on-line, or fill it out, print it and fax or mail it 
with payment to us. Thank you!
Referral: If known, please enter
ID number of person that refer you to us.
Referral ID
Enter your order here.
We ship daily. First come first served.

You will be contacted by us to confirm
your order.

We do dot charge your Credit Card
until product is in transit.

If items or not instantly available
you will be notified of the approximate
time of shipment.

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Enter your personal information here

Your entry must 
match the name and address 
on your credit card, or your 
bank may decline approval. 

All information is kept 
confidential unless 
you tell us otherwise.

First name
Last name
Business
Phone
Fax
Street
City
State
Zip/Postal
Email
Payment method accepted.
Credit Card, Money Order, 
Cashier Check.

Make checks and money orders :
Payable to TimcoUSA.

Please send this completed form
with your order. 

CARD NUMBER Expire
AMEX press Visa Master Card Discover
YOUR SIGNATURE :_______________________________
Vendor Mail -------->
Phone 800/663-8392
Fax 361/668-0036
Email TimcoUSA
TimcoUSA
Regional office
425 So. Reynolds St.
Alice, Texas 78332
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