Des Moines Stamp - Top Frame

Inspection Stamp Order Form

Order Placement Options

Stamp ID: Perma Stamp (Pre-Inked pencil cap)

Prices: 1-11 $9.00ea, 12-23 $8.00ea, 24+ $7.00ea

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

3/4"

Choose One Color

Black
Purple Green
Blue
Red

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:	Perma Stamp (Pre-Inked pencil cap)
Prices:	1-11 $9.00ea, 12-23 $8.00ea, 24+ $7.00ea
Purch Order#:

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

City:
State:
Zip:

Email:
Phone:
Fax:

Quantity
Size
3/4"
Choose One Color
Black Purple	Green Blue	Red
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.