PARTS ONLINE ORDER FORM

JIM'S AUTO PARTS

MOPAR PARTS ONLINE ORDER FORM

WHEN FILLING OUT THIS FORM, DO NOT PRESS THE "ENTER" BUTTON TO MOVE TO THE NEXT LINE. THIS WILL SUBMIT YOUR ORDER BEFORE IT IS FINISHED.

USE YOUR MOUSE OR TAB KEY TO MOVE FROM ONE LINE TO THE NEXT.

NOTE: IF YOUR ORDER IS LARGER THAN THE LINES ON THIS ORDER FORM, YOU MAY HAVE TO SUBMIT ADDITIONAL FORMS TO COMPLETE YOUR ORDER. PLEASE MAKE A NOTE IN THE COMMENTS BOX AS TO THE NUMBER OF PAGES TO YOUR ORDER AND WE WILL MAKE SURE THE ORDER IS FILLED AS ONE ORDER.

1.	ENTER YOUR VEHICLE INFORMATION:

YEAR, MAKE & MODEL:

BODY STYLE:

2-DOOR 4-DOOR HARDTOP (no post) CONVERTIBLE SEDAN (w/ post) FASTBACK

TRANSMISSION TYPE: AUTOMATIC 3 SPEED MANUAL 4 SPEED MANUAL

SEAT TYPE: BUCKET FRONTS BENCH FRONT

CARBURETION: 2 BBL 4 BBL 6 BBL CARBURETOR #:

ENGINE SIZE:

AIR CONDITIONING: WITH A/C WITHOUT A/C

POWER STEERING MANUAL STEERING

BRAKE SYSTEM: POWER BRAKES MANUAL BRAKES DISC BRAKE FRONT DRUM BRAKE FRONT

WIDTH OF RADIATOR CORE:
(width of finned area of radiator only, finned area where water runs through)
CHRYSLER PART NUMBER OF RADIATOR:
(7 digit number located on the top of the radiator; needed when ordering fan shrouds)

2.	ENTER YOUR NAME, BILLING AND SHIPPING INFORMATION:

First Name: Middle: Last Name:

*Please provide full first and last name as well as your middle initial; it is part of your customer number!
Individual's name is required! If credit card is a business card please enter individual card holders name in the space above. Company name can be entered in the billing and shipping boxes below.

PLEASE CHECK THIS BOX TO ACKNOWLEDGE THAT SOMEONE WILL BE AVAILABLE AT THE SHIPPING ADDRESS ENTERED BELOW TO SIGN FOR SHIPMENT DELIVERY.
SORRY, NO ORDERS WILL BE PROCESSED WITHOUT THIS BOX CHECKED.

BILLING ADDRESS:
(Please list the billing address where you receive your credit card bills. Make sure to include Street or PO Box, City, St, Zip & Country!) Please use a "separate line" for street address and City and State

SHIPPING ADDRESS:
(Please give a valid physical address that someone will be home to sign for your shipment. Signature is required for delivery!Fed Ex does not deliver to P O Boxes!) Please use a "separate line" for street address and City and State!!! All foreign orders must include a zip/postal code "and" a delivery phone number or orders cannot be processed!

PLEASE NOTE: IF YOU HAVE PREVIOUSLY ORDERED UNDER A DIFFERENT BILLING ADDRESS, PLEASE CLICK HERE AND LET US KNOW IN THE COMMENT SECTION OF THIS ORDER FORM, SO WE CAN UPDATE OUR FILES AND PREVENT MIS-SHIPPED ORDERS.

PLEASE NOTE: IF YOU HAVE PREVIOUSLY ORDERED UNDER A DIFFERENT SHIPPING ADDRESS, PLEASE CLICK HERE AND LET US KNOW IN THE COMMENT SECTION OF THIS ORDER FORM, SO WE CAN UPDATE OUR FILES AND PREVENT MIS-SHIPPED ORDERS.

DAYTIME PHONE NUMBER*:

DELIVERY PHONE NUMBER (if different than above)*:

FAX NUMBER:

EMAIL ADDRESS:

* Please note: Email address is necessary to place an order!!!

* Daytime phone number, delivery phone number & email address must be included with all on line orders.

3.	ENTER YOUR PAYMENT INFORMATION:

VISA MASTERCARD DISCOVER
CARD #	MONTH & YEAR EXP. DATE:
**(Credit card number should contain 16 digits; re-check to make sure you entered the full credit card number)**
SECURITY NUMBER (should be 3 digits in white signature stripe on back of card)
GIFT CERTIFICATE REDEMPTION
Please enter the gift certificate number under the comments section in the lower part of this section.

4.	ENTER YOUR PARTS ORDER: (Use the tab key or mouse to move from one box to another! Hitting the "ENTER" key will submit your order.

QTY	PART #	DESCRIPTION	Specify SIZE/COLOR	PRICE EA	ITEM TOTAL

Please specify what source you are ordering this order from:
(select only one, please)

Our Website Catalog (Specify Catalog #) Other (Specify other source)

ORDER INSTRUCTIONS & COMMENTS:

GIFT CERTIFICATE REDEMPTION:
To redeem a gift certificate, please enter the certificate number, the amount here and email address here.

GIFT CERTIFICATE NUMBER:

GIFT CERTIFICATE AMOUNT:

EMAIL ADDRESS TO SEND CERTIFICATE:
(if that delivery option is requested)

Have you ordered parts from Jim's Auto Parts before?
YES NO

If so, please entered your customer number here:

PLEASE READ BEFORE SUBMITTING ORDER!!!
SUBMISSION OF ORDER
Please note: After submission, you will see a page that shows all the items you placed on your order form. This is not an email, but a one page confirmation of the items you ordered. The only email you will receive is an email with the tracking number of your shipment once it has been sent. Please note, if an Expedited Air shipment option is selected, this only will assure that your shipment will arrive in the selected number of days from its ship date. Although we will do everything possible to ship your order as soon as possible, it does not guarantee that your order will be shipped the same day as it is placed.
PRICING
All prices, part numbers and availability of parts on this site are subject to change without notice. Parts superseded will be shipped automatically. The price of the superseded part may differ from the ordered part. If a return is desired due to cost of supersedence, no handling/restocking charge will apply.
RETURNS
We will replace any item which has been incorrectly shipped, or any item which has been determined to be defective within 30 days of invoice. All other returns must have an RMA number and be returned within 30 days. Any return to stock items will be assessed a 20% handling and re-stocking fee. No returns on electrical, fuel or special orders. All returns must be made by Fed Ex, UPS or DHL to our 40 Lowell Rd, Salem, NH 03079 street address.
Sorry, no US Mail returns will be accepted. Anything sent back by US Mail will most likely be returned by the post office.
DAMAGES
FED EX OR UPS: In the event a package received appears damaged, please have the driver note upon delivery and call us to report damage .If the package is left at your address, please call us immediately to report damage.
COMMON CARRIER: Upon delivery of any shipment, you must inspect thoroughly for damage before accepting any shipment. Any damage must be noted on the Bill of Lading (delivery receipt) to ensure claims for damage. Any claims for damage must be handled directly with the carrier. If you have any questions or need a phone number for the carrier, please call us.
SHIPPING & HANDLING COSTS
We do not approximate shipping & handling costs and charge upon receipt of order. Costs are determined by several factors including weight, size, number of boxes, etc. As there is no way of determining how the shipment will be packaged ahead of time, there is no way of quoting the true costs associated with your shipment until it is processed. Your shipping & handling amount will be added to your invoiced total when the order has been processed and is ready to ship.

pLEASE NOTE: ALL ADVERTISED PRICES, PART NUMBERS AND AVAILABILITY ON THIS WEBSITE ARE SUBJECT TO CHANGE WITHOUT NOTICE.

AS WE TRY TO KEEP THE THOUSANDS OF PARTS ON THIS WEBSITE UPDATED AS FREQUENTLY AS POSSIBLE, PLEASE BE AWARE THAT ALL LISTED PRICES ON THIS WEBSITE ARE SUBJECT TO CHANGE.

PLEASE CALL CUSTOMER SERVICE AT 603-898-0535 (10 am to 6 pm M-F) FOR LATEST PRICING AND AVAILABILITY bEFORE ORDERING.

SUBMISSION OF ON-LINE ORDERS THROUGH THIS WEBSITE CONFIRMS CONSUMERS KNOWLEDGE THAT THEY ARE ADVISED TO CALL CUSTOMER SERVICE TO CHECK ON PRICE AND AVAILABILITY IF DESIRED, AND THAT ANY ADVERTISED PRICES ON THIS WEBSITE ARE NOT GUARANTEED. ORDERS WILL BE PROCESSED WHEN SUBMITTED FROM THIS SITE AT THE CURRENT PRICE, REGARDLESS OF PRICE ENTERED BY CUSTOMER ON ORDER FORM. PARTS SUPERSEDED WILL BE SHIPPED AUTOMATICALLY. THE PRICE AND DESCRIPTION OF THE SUPERSEDED PART MAY DIFFER FROM THE ORDERED PART.
SUBMISSION ALSO CONFIRMS CUSTOMERS KNOWLEDGE OF OUR ORDERING AND RETURNS POLICY.

*When submitting an order, please do not submit your order more than once. Remember to use your mouse or the tab key to move around form. Pressing "enter" will submit your order! If your order is accidentally submitted, order will be deleted as incomplete orders are not accepted!!!