Des Moines Stamp - Top Frame

Inspection Stamp Order Form

Order Placement Options

Stamp ID: Cast Aluminum Inspection Stamp

Prices: 1-20 $8.00ea, 21-40 $7.50ea,
41-60 $7.00ea, 61+ $6.50ea

Purch Order#:

Ship & Bill to:

Company Name:

Attention:

Address:

P.O. Box:

City:

State:

Zip:

Email:

Phone:

Fax:

Would you like a Sales Rep. to contact you? Yes
No Would you like a Catalog? Yes
No

We'll ship open account to all qualified accounts.

Tax and shipping delivery charges will be added to the invoice.

Quantity

Size

1/2" 3/4"

Border

Round
Square No Border
Other

Please remember to NOT hit the ENTER KEY to move to the next line.
Use the TAB key to move from line 1 to line 2....

Line

Enter Line Information

1

2

3

4

5

6

7

8

9

10

Special Instructions
To order with your credit card,
please enter a phone number for us to contact you.

Please use your browsers Print before hitting the "Submit Order" button if you require documentation.

Would you like a Sales Rep. to contact you?	Yes No	Would you like a Catalog?	Yes No
We'll ship open account to all qualified accounts. Tax and shipping delivery charges will be added to the invoice.

Stamp ID:	Cast Aluminum Inspection Stamp
Prices:	1-20 $8.00ea, 21-40 $7.50ea, 41-60 $7.00ea, 61+ $6.50ea
Purch Order#:

Ship & Bill to:
Company Name:
Attention:
Address:
P.O. Box:

City:
State:
Zip:

Email:
Phone:
Fax:

Quantity
Size
1/2" 3/4"
Border
Round Square	No Border Other

Please remember to NOT hit the ENTER KEY to move to the next line. Use the TAB key to move from line 1 to line 2....
Line	Enter Line Information
1
2
3
4
5
6
7
8
9
10
Special Instructions To order with your credit card, please enter a phone number for us to contact you.

Please use your browsers Print before hitting the "Submit Order" button if you require documentation.