Payment
Method:
Dual Sport America/Dual Sport Tech 5% Discount Order Form
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Ship to: (We must verify and ship to the billing address and phone number for your credit card.)
Name _______________________________________
Year ________ Make__________________
Model ______________________________
Shipping Information:
When paying by credit card USPS or similar
shipping, a $12 shipping and handling charge will
be added to your total. When prepaying by check,
add $12. Make check out to LEE SHAW/DST
Street __________________________ Apt.# ________
City ________________________ ST _______________
Zip ________________
Home Phone (____)___________________
Work Phone (____)____________________
Email ________________________________________
Qty Part# Description Price ea. Total
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5% Discount for Mail-in Orders
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Shipping (see shipping info above)
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Master Card:
American Express:
Money enclosed:
Card # ________________________________________
Exp. Date ________ CVV ______
Signature ___________________________________________
I have read and understand the company policy below.
Absolutely no refunds or returns. All sales are final.
DAMAGED PARTS: All parts leave our shop in good condition, and are tested prior to being shipped out. If parts are received damaged, immediately call the
shipping company to file a claim. Damaged parts are warranted on an exchange basis only, absolutely no refunds.
SHIPPING CHARGES: All shipping charges are the customer's responsibility. We do not pay any shipping charges. I authorize DST to charge my credit card
for any and all shipping charges.
AGREEMENT ON JURISDICTION ON DAMAGES: DST and Customers agree that any suit, claim or legal proceedings of any nature between the parties must
be filled and prosecuted in Riverside County, CA and shall be controlled by the laws of the State of California then in effect. DST warrants all parts are in good
condition and in working order. Any parts that are defective will be replaced. DST liability shall be limited to the original price of the goods and that DST
shall not be responsible for exemplary, punitive or consequential damages or labor charges. If the buyer fails to pay as agreed, the buyer agrees to pay all
attorney's fees, court cost, expenses and interest incurred by DST in the collection of all sums. The buyer assumes all responsibility regarding the conversion of
a vehicle from off to on road, and agrees to check with their state's requirements.
Print this form and mail to:
Lee Shaw/ Sales - DST
1450 Timberlane Drive
Riverside, CA 92506
Visa Card: