Copyright (C) 1996-2017 Santronics, Inc. All Rights Reserved
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MAIL-IN ORDER FORM
PLEASE PRINT CLEARLY

TODAY’S DATE:______/______/______

YOUR SHIPPING ADDRESS:

FULL NAME:______________________________________________________________________________

ADDRESS:______________________________________________________APT/SUITE #:______________

CITY/TOWN:_______________________________________________STATE:________________________

ZIP CODE:___________________________



YOUR BILLING ADDRESS: (If different from above)

FULL NAME:______________________________________________________________________________

ADDRESS:______________________________________________________APT/SUITE #:______________

CITY/TOWN:_______________________________________________STATE:________________________

ZIP CODE:___________________________


YOUR E-MAIL ADDRESS:_________________________________________________________________

YOUR PHONE NUMBER:__________________________________________________________________

ITEM ORDERED: SETSMV4

QUANTITY: 1

PRICE EACH IN $U.S.: $120.00

ADD NJ SALES TAX: 6.875% = $8.25

TOTAL PRICE: $128.25

Please make your payment using a cashier’s check or money order, payable to Santronics inc., in the amount of $128.25. This amount already includes shipping cost for 1st class, certified mail with proof of delivery, via U.S.P.S. THANK YOU FOR YOUR ORDER.
SANTRONICS