Fuel Injector Man

5307 Shirley Street, Suite W

Naples, Fl. 34109

1-888-771-3835 (239) 591-3332

Name : ____________________________________________________ Date : ________________

Shipping Address :________________________________________________________________________

City : ____________________________________________ State : _____________ Zip : _____________

Phone : ______________________________ E-Mail : ___________________________________________

E-Tec Fuel Injectors

Please send Housings with all Injectors so we can set injectors and test in your housings.

All E-Tec Fuel Injectors are $62.00 each which includes Seal Kits.

Year of Engine : ____________ HP Of Engine ________________ Model :______________________

Injector #1 Serial Number ___________________ Injector #2 Serial Number ___________________

Injector #3 Serial Number ___________________ Injector #4 Serial Number ___________________

Injector #5 Serial Number ___________________ Injector #6 Serial Number ___________________

Return Shipping / We currently use UPS

Please select how you would like your injectors returned shipped. UPS Ground ___ UPS Next Day ___

Your package is insured for $100.00 only ! Additional Insurance is 1.00 per $100.00

Extra Insurance : _____________________ ( $100, $200, $300, $400, $500 etc. )

If you choose not to carry extra Insurance for the Return Shippment

Fuel Injector Man will not cover the cost of replacing your injectors due to lost shipments

We Strongly recommend that you buy enough Insurance for you to replace your Injectors !

Payment

Fuel Injector Man uses PayPal " Pay By Invoice "

When we receive your injectors we will send you an E-mail / Invoice through PayPal.

The Invoice will show cleaning cost + shipping. Click on the link on the E-mail / Invoice to pay.

You can use any credit card Or a PayPal account to pay the invoice.

PayPal will send us back an e-mail stating that you have paid the bill.

We will send back your injectors at that time.

This is the safest way for you and us. PayPal site is secure/safe/and easy !

We do not see any credit card information which protects You !

You Must supply your e-mail address to get billed.

Thank You For your Business !