FAX ORDER FORM
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Please fax this form to 817-759-1004.  Please include your phone number so we can call if we have questions.



Bill to:

____________________________________________________________________
Account Number Company Name Your Name
____________________________________________________________________
Complete Address
Type of Business
(___)________________  _ (___)_________________________________________
Phone Number Fax Number Purchase Order Number



Ship to:

____________________________________________________________________
Company Name
Attention
____________________________________________________________________
Complete Address City State               Zip
____________________________________________________________________
Delivery Instructions (if required)

Prefix/Item Number
Color Page Description Quantity/
Unit
Unit
Cost
Extended
Cost































































Need more room? Just attach an additional sheet of paper.
Merchandise Total ___________

Sales Tax ___________

TOTAL ___________
Payment Method: [ ]Cash        [ ]Check        [ ]Company Charge# ____________
Card (Name)_____________________________________________
Card # ________________    Exp. ______      Signature ____________________