Used Auto Parts - Pay By Check

The only form of check payment is a Bank certified check

We do not accept personal checks. Make checks payable to Harbor Auto. Print this form and fill out the following information and mail the check and the form to:

Harbor Auto - Used Parts Division
480 Lynnway
Lynn, MA 01905

Call us if you have any questions
Phone: 1-781-593-3344 | Fax: 1-781-596-0109

	Billing Information
Your Name:	_________________________
Business:	_________________________
Address:	_________________________
Your Email:	_________________________
Day Phone:	_________________________
Fax:	_________________________
City:	_________________________
State:	_________________________


	Shipping Information (if different from above)
Ship To Name:	_________________________
Address:	_________________________
City:	_________________________
State:	_________________________
Contact Person:	_________________________
Phone:	__________________________

	Vehicle Information
Year:	_________________________
Make:	_________________________
Model:	_________________________
V.I.N.:	_________________________
Production Date:	_________________________
Part Type:	_________________________
Quoted Price:	_________________________
Shipping Price:	_________________________
Salesperson:	_________________________

I would like to receive a confirmation via:

E-mail Telephone

I understand on shipping charges that there are no refunds.
Harbor Auto warranties for replacement only.

Signature _________________________