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Name: Address: City: State: Zip Code: E-mail: Phone Day: Phone evening: Year, Make, Model of Vehicle Approx. Pick-up Date Is vehicle Operable Your Salesperson PICK UP FROM: Name: Address: City: State: Zip Code: Phone Day: Phone evening: DELIVER TO: Name: Address: City: State: Zip Code: Phone Day: Phone evening: TOTAL COST LESS DEPOSIT: $200.00 BALANCE DUE CLIENTS NAME E-Mail: carshipperusa@aol.com Per Agreement Term Deposit is Non-Refundable if Order is Cancelled! Special Instructions: $200.00 Deposit Required Money Order or Cash Send Priorty Mail, UPS or FEDEX Payable To: Car Shipper USA, LLC 14661 S.W. 23rd Ct. Davie, Florida 33325 - USA
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E-Mail: carshipperusa@aol.com
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