Order Form

Name _________________________________________________________________

Address _______________________________________________________________

City_____________________ State ____________ Zip Code ___________________

Phone ____________________________________________

Email address___________________________________________________________

Bill and Ship To address the same- Yes_______ No________

Custom Series requested (i.e. El Diablo) ____________________________________ (if no series, "custom Ruger®")

Caliber ________________________ Barrel Length - Octagonal________________ Round__________________

Sights (mark one)
Standard Ramp with white outline rear
Gold bead or Red Fiber Optic or Green Fiber Optic with V rear (circle one)

Free Wheel cylinder (circle one) YES NO        Special Features (list here)

GRIP STYLE (mark one)
Birdshead (Tombstone Classic Style)
Gunfighter Grip
Gambler's Grip (Doc Holliday Style)
Standard Factory

GRIPS (mark one)
Laminated Walnut, Cherry, or Ironwood
Ivory Max
Other___________________________

Do you want your name or a cowboy handle engraved on the gun? If so, print it below:

 

FINISH (mark one)
Stainless. High Polish
Stainless. Vapor Honed
Black Chromex. High Polish
Black Chromex. Vapor Honed Satin Black
Two-toned. Specify below:

Special Engraving. Special engraving, such as group logos, special badges, presentation wording, or any pictures or drawings you need engraved on the gun, adds $150 per scene or drawing. Show special engraving below or enclose your logos, etc. Please list special engravings below.........

 

Porting or Muzzle Brake
Magnaport $300 (mark one) - YES NO
Muzzle Brake $300 (mark one) - YES NO

To be built on your gun? (mark one) - YES NO If on your gun, list the
serial number _____________________________

Deposit _______________________________

Credit Card Number (if applicable) ________________________________________________________________________ DEBIT / CREDIT (circle one)
expiration date _______________ 3-digit code ___ ___ ___

We try to deliver your custom gun in the time frame listed on our website, but due to shortages or backorders from various suppliers such as grip makers, steel suppliers, engraving templates, and many others upon which we have no control, we may, from time to time, go over the expected time period. We hope you will understand this and be flexible. If you have to have the gun by a certain date for a hunt or special event, make sure and let us know at the time of the order. Any order cancelled will be subject to a 10% penalty and payment for any templates or engraving stencils.

Due to liability, the inner parts of your gun replaced during a conversion cannot be returned.

Your Signature ______________________________ Date ________________

 

Any post-order changes must be made in writing.