Heavy Duty Self-Inking order form

FAX/MAIL ORDER FORM.....RS-AC

Print this form , Fill it out and FAX or Mail it to us.

Your Info.

.

Name .......................................................................

Company .................................................................

Address ....................................................................

City ........................................................................

State ............................. Zip Code .............................

Phone # ...................................................................

Fax # ......................................................................

E-mail .....................................................................

URL ........................................................................

Your P.O.# ....................................

Draw or Place Your Stamp Copy and Notes Here.........

Quantity: ..........................

No. ...MX .........................

No. of Lines ....................

Price ea. $ ........................

State Tax
Calif. Only 9.25% .....................

Shipping UPS ground

all order's - any quantity $ 12.50

Draw or Place Your Stamp Copy and Notes Here:

NOTICE: We do not always have all models in stock & it may take 5-7 working days to ship.
IF you need a model sooner - Please call 626-333-2450 to check availability.

Advance Payment Required
No Returns Allowed on Custom Products.
25% Restocking Charge on Returned Stock Items.

...Method of Payment.............For Safety, Don't send credit card details over the Internet.

Master Card............ Visa............ American Expres......... Discover....... CHECK By Mail ............

Credit Card #... .... ......... .... .... .... ................... .... .... .... .....Expiration ...... / .........Billing ZipCode ...................