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Your Information:

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Email Address

Phone Number

FAX Number

Receive confirmation
of this order

By Phone By FAX By Email
No Confirmation Necessary

Billing Information:
Name
Company
Address
P.O. Number
Account Number (If Known)

Shipping Information:
Same as above?	YES NO (If "yes", then skip to "Order Information" section)
Name
Company
Address (NO P.O. Boxes)
P.O. Number
Is this a drop-shipment to a third party?	YES NO

Order Information:
Quantity	Item #	Description	Net Price

TERM OF SALE

PAYMENT TERMS
(1) Net 30 Days Billing Terms will be established upon approval
from our Credit Department.
(2) New accounts first order C.O.D.
(3) Sales tax collected from NY & CA residents.

SHIPPING PROCEDURES
(1) All orders are shipped via UPS unless otherwise specified.
(2) Returns must have Return Authorization Number.
(3) Prices and packaging subject to change without notice.
(4) Minimum order $50.00.

Send questions and comments to orders@microfilmproducts.com or call 1-800-642-7668.