Woodwiz®Splitter Printable Order Form 

For VISA or Mastercard, checks or money orders:

Please print this page, fill out and mail to:

Easy Motion Inc.
400 Bunn Hill Rd
Vestal NY 13850

Ordered by:
Name__________________________________________________
Address________________________________________________
City_________________________ State_____ Zip________
Daytime Phone___________________________________________
Email address:___________________________________________

Ship to:
Name__________________________________________________
Address______________________________(no P.O. Box please)
City_________________________ State_____ Zip________
Daytime Phone___________________________________________
Email address:____________________________________________

Shipping via USPS Ground. For each splitter please add $40 shipping and handling

Quantity of Splitters Ordered  _______
Cost of Splitter(s): $149.95 x quantity = $_______
S&H: $40.00 x quantity = $_______
For New York State residents only: Please add $12.00/unit (8% sales tax) = $_______
Total Cost     $_______

Charge my (check one): ___VISA    ___Mastercard
Name on card: ___________________________________
Card number: ____________________________________
Expiration Date:______________
CVV:______________

OR:  Enclose CHECK or MONEY ORDER payable to:Easy Motion Inc.

Ten day money back guarantee.  One year warranty parts and labor.