Laser Copier Cartridges .com offers affordable laser printing supplies with a large array of matched laser toners, specially manufactured replacement laser parts, recharged laser toner print cartridges and genuine laser toner print cartridges and drum cartridges
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Authorized Purchasers Form

Use the form below to authorize multiple persons within your company or organization to place orders on your behalf. This form also authorizes Laser Copier Cartridges .com to ship orders for your company or organization to multiple locations (other than the corporate or billing address). Please fill out the form completely and either fax it to us at (503) 643-5379 or mail it to:

Laser Copier Cartridges .com
10200 SW Eastridge St., Suite 105
Portland, OR 97225

As soon as we receive this form from you, any pending orders awaiting receipt of this form will be processed promptly. If you are paying by credit card, please be sure that the billing address you provide matches the address your bank or credit card company has on file for your credit card.

If you have any questions, please email sales@lasercopiercartridges.com.

Laser Copier Cartridges .com Authorized Purchasers Form
Date Received:
By Whom:
Please fill in all fields below, as applicable:
Name: Position:
Company/Organization:
Corporate Shipping Address:

 

 

 Billing Address:

 

 
Telephone Number: Credit Card #:
Fax Number: Expiration Date: CVV #*:
Email Address (to receive order confirmation):

*The CVV number is located on the back of your card, above the signature area

I authorize the individuals named below to place orders using the (circle one) corporate/personal credit card listed above for shipment from Laser Copier Cartridges .com to their respective locations.

Authorized Purchaser

Location

Shipping Address

1.

    

2.

    

3.

    

4.

    

5.

    

 

I am the (or one of the) authorized account holder(s) of the credit card number above.

I understand that the individuals named above will be free to place orders for my company without my verbal or written permission from the time I submit this signed form to Laser Copier Cartridges .com, unless and until I contact Laser Copier Cartridges .com in writing to rescind this authorization.

I have read, understood and agree to be bound by the Terms and Conditions of Sale (see http://lasercopiercartridges.com/terms.htm [link]) and the Return Policy (see http://lasercopiercartridges.com/returns.htm [link]) currently in effect.

Signed:_____________________________________________   Date:_________________

 

Terms and Conditions of Sale
Copyright 2008 Laser Copier Cartridges .com. All Rights Reserved.
Laser Copier Cartridges .com is not affiliated with any OEM manufacturers. All manufacturer names and logos are
registered trademarks of their respective owners and are used here for identification purposes only.