Contact Laser Copier Cartridges .com -- Order Form

Laser Copier Cartridges .com Order Form

Date Received:
By Whom:

Please fill in all fields below, as applicable:

Name:
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

Part #	Description	Qty	Price	Total




Shipping (UPS or USPS)
Handling
Order Total

There will be a handling fee added to all international orders.

I understand that Laser Copier Cartridges .com will not be held liable for lost or stolen packages shipped via USPS.
I understand that Laser Copier Cartridges .com will not be responsible for additional fees.

I am the authorized account holder of the credit card number above.

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 2004 - 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.