PlumbingSupply.com Printable Order Form - Please print very clearly

Name:


Date:



Shipping Address:




Billing Address (if different):




Email (please print clearly):

Day Phone:

Fax:

Please check here if you're a returning customer: [   ]

Payment Method:
[  ]VISA, [  ]MasterCard, [  ]Discover, [  ]Money Order, [  ]Check #
C.C. Expiration: CreditCard#: Security Confirmation Numbers:
For information regarding the location of your credit card's Verification Code, go to www.PlumbingSupply.com/verify.html.
If the name or address where your credit card statement is sent is different from shipping address above, please enter that info below:




I have read and agree to your return policy:   X__________________________________

Shipping Method: [ ]Standard, [ ]2nd Day, [ ]Priority Mail

QtyDescription/Model#Cost Ea.Total
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
Product Subtotal  
Standard shipping rates (view rates)  
Shipping UPS 2nd Day Upgrade (view rates)  
Shipping USPS Priority Mail (view rates)  
Subtotal  
California Residents add 7.25% Sales Tax  
Total  

If paying by check or money order, your order will be held for the amount of time shown here.

PlumbingSupply.com, 994 East 20th St. Chico CA 95928
Fax: 530-891-0654; toll-free Fax: 866-744-0521, CreditCard: 530-891-1556, Email: sales@plumbingsupply.com
Our Return Policy: www.PlumbingSupply.com/return.html - FAQ's: www.PlumbingSupply.com/faq.html

Click here to go to our front page