FAX ORDER FORM

FAX ORDER FORM

PLEASE PRINT THIS FORM, WHEN COMPLETED FAX TO

1-228-868-8245

PLEASE CHOOSE ONE: O REGULAR WOOD HANDLE O SELF INKER O DATER O SEAL

SELF INKER:

Ideal 50 (up to 3 lines) _____ Qty. ____ Color _____ $19.00

Ideal 100 (up to 4 lines) _____ Qty. ____ Color _____ $20.00

Ideal 200 (up to 6 lines) _____ Qty. ____ Color _____ $22.00

Ideal 300 (up to 8 lines) _____ Qty. ____ Color _____ $25.00

Refill Ink: 6cc _____ Color _____ $3.20 2 oz. _____ Color _____ $6.50

REGULAR WOOD HANDLE

First Line $7.00 Stamp Pad: Blue _____ Red _____ Black _____ Green _____ 2-3/4x4-1/4 $6.25

Each Add’l. $2.00 2-3/4x4-1/4 $6.25 3-1/4x6-1/4 $8.75 4-1/8x7-1/2 $14.75

NOTARY SEALS

Pocket Seal: 1-5/8" _____ $48.00 2" _____ $55.00

DATERS: Ideal 6510

Plate Size: 1-1/8"x2 1 color _____ $39.50 2 color _____ $41.50

TYPE STYLE:

1 Helv 2 Helv 3 Helv 4 Times 5 Times 6 Times 7 Brush

1a HELV 2a HELV 3a HELV 4a TIMES 5a TIMES 6a TIMES

PRINT INFORMATION HERE

(SPECIFY ON RIGHT - TYPESETYLE AND ALIGNEMNT (Flush left, center or flush right)

Type Alignment

________________________________________________________________ ______ _________

CUSTOMER INFORMATION: NAME/CONTACT: __________________________________________

ADDRESS: ______________________________________________ Phone: ___________________

SHIP TO: _________________________________________________________________________

_________________________________________________________________________________

**WE USE PRIORITY US MAIL FROM $3.50 - $8.00 DEPENDING ON WEIGHT.

BILL TO: _________________________________________________________________________

PAYMENT METHOD: O VISA O MASTERCARD O AMEX

CARD HOLDER: ___________________________________________________________________

CARD NUMBER: _______________________________________ EXPIRATION DATE: __________

PLEASE CALL IF YOU PREFER TO GIVE NUMBER OVER TELEPHONE: 228-868-8244