Contact information

Name: Phone: E-mail: Street adress: Car make or model: Billing address (if different):

Post code: Country: Customer number (if any): Preferred delivery date (2 weeks for deliver): Type and year model:

Seat set information

Headrests front: Armrests front (kpl): Airbags :

Headrests back: Armrests back: More information of your car:

Delivery information

Amount of order (pcs/series) Brand: Model number/Price group: (not compulsory)

Colour: Color of the imitation leather side: Note:

Your order is
Order Inguiry

Doors
2 3 4 5

Back rest
1 2 3 4

Back seat
1 2 3 4

Pockets
Passenger seat Driver's Both No

Electic heating systems
Passenger seat Driver's Both No

Delivery
Post Transpoint VR freight Freight-liner C.O.D. advance Carried Pickup

Carriage is paid by
Sender Receiver