Basic HTML Version
DELIVER TO:
Name_ _____________________________________
Title_ _______________________________________
County or City________________________________
Physical Address______________________________
_ __________________________________________
email_______________________________________
Fax Number_ ________________________________
Phone Number_ ______________________________
Method of Shipping
Least Expensive
Must Receive By “Date Needed By” Below
_ ___________________________________
Questions or Requests
_ __________________________________________
_ __________________________________________
_ __________________________________________
Easy Order Fax Form
Fax to: 336.578.6597
INVOICE TO:
Name_ _____________________________________
Title_ _______________________________________
County or City________________________________
Mailing Address_______________________________
_ __________________________________________
email_______________________________________
Fax Number_ ________________________________
Phone Number_ ______________________________
Method of Payment
Purchase Order #: _ ___________________________
Bill the person listed in “Invoice To:” section above.
Charge To: AMEX MasterCard Visa
Card #______________________________________
Expiration Date:_ _____________________________
Credit Card Billing Name (required):
_ __________________________________________
Item Code
Color
Description
Date Needed
By
Quantity Unit Price Extended
Price
Coupon Code:
TOTAL:
Shipping Additional
Returns must be authorized with RMA# in advance. Restocking fee may apply. Prices and availability subject to change without notice.
Store
www.intab.net
Phone
800.232.1872
Fax
336.578.6597
INTAB
PO BOX 1160
MEBANE NC 27302
www.intab.net
1.800.232.1872
www.intab.net
1.800.232.1872
www.intab.net
1.800.232.1872
www.intab.net
1.800.232.1872
PRESORTED
STANDARD
U.S. POSTAGE PAID
MEBANE, NC
PERMIT NO. 43
TM
Tamper Evident Solutions