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E-Z Rental Order Form

First Name Last Name

Street Address

City State Zip

(Telephone) Area Code Number (Cell Phone) Area Code Number

E-Mail Requested Delivery Date Month Day

Check Items For Delivery then click the Submit Button........ * (Delivery Charge $20 in most areas)

All Rates are Monthly, * Rent to Own.... Add %7.75 Tax

Payment due on delivery (Visa,MC,AMEX,Checks,Checks by Phone, Cash, Money Orders)

WASHER/DRYER SET

$35 Rent to Own $55 ... ....................Dryer Gas Electric

MILITARY ONLY DISCOUNT $5 OFF ON WASHER/ DRYER SET

$30 ... ....................Dryer Gas Electric

SINGLE WASHER

$20 Rent to Own $25

SINGLE DRYER

$20 Rent to Own $25 ........................Dryer Gas Electric

STACK WASHER/DRYER (23 7/8 Inch Wide)

$35 Rent to Own $62.50................... Dryer Gas Electric

FULL STACK WASHER/DRYER (27 Inch Wide)

$45 Rent to Own $82.50................... Dryer Gas Electric

REFRIGERATORS (CU=cubic feet) (Wire=Wire Shelves) (Glass =Glass Shelves)

16 CU WIRE $25 Rent to Own $31.50

18 CU WIRE $27.50 Rent to Own $35.50

18 CU GLASS $30 Rent to Own $37.50

25 CU GLASS $45 Rent to Own $56

21.6 CU GLASS, TOP MOUNT FREEZER $35 Rent to Own $56

FREEZER

Monthly Rental $30 Rent to Own $42.50

Click the Submit Button to place the order...

* Delivery to most areas $25, $10 extra for stairs. Call for exact quote 760-560-0629 Gas line and valves not included. Hook up on water not included for ice & water refrigerators 3 month minimum contract in San Diego North County, 6 month minimum contract for San Diego South County.

* RENT TO OWN IS BASED ON A 24 MONTH CONTRACT WITH FREE SERVICE FOR MANUFACTURER DEFECTS ONLY FOR THE TERM OF THE CONTRACT