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: [ ]UPS Ground, [ ]UPS 2ndDay*, [ ]Priority Mail*

QtyDescription/Model#Cost Ea.Total
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
Product Subtotal:  
Shipping - $999.99 or less is 8%, $1000 to $1999.99 is 5%, $2000 to $4999.99 is 2%, $5000 or more is FREE  
U.S. Priority Mail or 2nd Day UPS Upgrade (we will add):  
Processing - Under $20 is $6.75, $20 to 49.99 is 4.75, $50 to $149.99 is $3.50, orders $150 or more processing is FREE:  
Subtotal:  
California Residents add 7 1/4% Sales Tax:  
Total:  

PlumbingSupply.com, 994 East 20th St. Chico CA 95928
Fax: 530-891-0654; toll-free Fax: 866-744-0521, CreditCard: 530-891-1556, Email: Sales2008@PlumbingSupply.com
Our Return Policy: www.PlumbingSupply.com/return.html - FAQ's: www.PlumbingSupply.com/faq.html
* Note: Shipping methods other than UPS Ground cost more.

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