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Please fill out the information in each section as requested. Supply your name, contact information, and information about the equipment. Then submit or print out and fax to 800-533-2740. You will receive a confirmation message from us shortly. Thank you.   Name: Title: Company Name: Address: City: State: Zip: Phone: Fax: E-Mail: I would like Customer Service to call me. Equipment and Paper used Printer:               Make: Model: Make: Model: Make: Model: Make: Model: Credit Card Machines:      Make: Model: Make: Model: Make: Model: Make: Model: Point-of-Sale or Cash Register System:      Make: Model: Make: Model: Make: Model: Make: Model: Fax Machines:                     Make: Model: Make: Model: Make: Model: Make: Model: Computer Paper: Size: Number of Parts: Size: Number of Parts: Make: Model: Make: Model: Please enter any additional comments or questions regarding our products or services, i.e., special orders, printed guest checks, etc.: Thank you for taking the time to answer the questions in our survey. Please submit or Print and Fax your request to: 1-800-533-2740, or Call 1-800-533-2737. We will reply shortly with a quote for the supplies your equipment uses. If you did not have enough room on this form, please submit multiple forms.

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