Laser Toner Services -- Laser Toner Cartridges -- Fax Order Form for laser toner cartridges

Contact Information

Contact Title/Name:

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Comments/Questions/Remarks:

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Business Name:

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Address:

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City:

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State:

___________

Zip Code:

___________

Phone#:

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Fax #:

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Order Information
(Please print out the Product Listing)

If you are unsure of which product you need, please include the Manufacturer and Model of your equipment and we will be happy to assist you. If you have any questions, MAIL our sales staff.

Item 1		Item 2
Printer/Copier/Fax Manufacturer:	____________________	Printer/Copier/Fax Manufacturer:	___________________
Printer/Copier/Fax Model:	____________________	Printer/Copier/Fax Model:	___________________
Order Number:	____________(required)	Order Number:	___________(required)
Quantity:	___________ (required)	Quantity:	__________ (required)
Price:	___________	Price:	_________


Item 3		Item 4
Printer/Copier/Fax Manufacturer:	_________________	Printer/Copier/Fax Manufacturer:	________________
Printer/Copier/Fax Model:	_________________	Printer/Copier/Fax Model:	________________
Order Number:	____________ (required)	Order Number:	___________ (required)
Quantity:	___________ (required)	Quantity:	__________ (required)
Price:	___________	Price:	__________

Product Total:	$ _________	To compute shipping: Add $4.95 for your first item. Add $.95 for each additional item. For orders of more than 25 items, shipping is FREE!!! Delivery is FREE in the Greater Omaha Area.
Shipping:	$ _________
Order Total:	$ _________

Payment by:

Credit Card

Visa
Card Number: Expiration Date:

MasterCard
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Other Arrangements
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Please print this form, fill it out, and fax to (402) 293-8334. If you have questions or concerns, please email the Sales Staff or call Laser Toner Services at (402) 292-2950 or (800) 249-9573.