Sample Order Form

SAMPLE ORDER FORM

Please fax this completed form and a copy of your purchase order to



CID #



Date: April 10, 2013 Purchase Order #

ADDRESS

Phone:

Name: Name:

Fax:

E-mail: Company: Company:

Web: Bill To Addr. Ship To Addr.

City: City:

County: Fresno County State/ZIP

State/ZIP Phone:

Phone: Fax:

Fax: Email:

Email:



Credit Card: Card Number: Exp. Date

Cardholder Name:

Visa Master Card



Discover American Express

Signature:





Item Code/Paper Type Product Description Size Length Quantity Price Each Total

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Subtotal: $0.00

Tax: 7.875% $0.00

TOTAL: $0.00

Instructions on how to fill out the required fields on the order form:



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Item Code/Paper Type Product Description Size Length

8650000042 20# inkjet bond 36" roll 300 ft