Data ID Order Form Please provide the following order information

CUSTOMER BILLING INFORMATION
Today's Date
First Name
Last Name
Company Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code	Country
Email Address
Phone Number
Fax Number
Select	Payment Option Credit Card C.O.D. Invoice Invoice Go To - Credit Application Form
Paying by Credit Card	Select Card Type VISA MasterCard American Express Discover Go To - Credit Card Authorization Form
CUSTOMER SHIPPING ADDRESS (if different than Billing information)
First Name
Last Name
Company Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code	Country
Delivery Address	Business Residential
Email Address
Phone Number
Shipping Method	Choose one UPS Brown UPS Orange UPS Blue UPS Red FED-X Priority FED-X Saver USPS
Tax Status	Choose One Taxable Non-Taxable Government Exempt Out-of-State
Resale/Tax Exempt Number
Comments/Special Instructions

CUSTOMER ORDER INFORMATION
QTY	ITEM NUMBER	ITEM DESCRIPTION	UNIT PRICE	EXTENDED AMT
			SUB-TOTAL
			Freight
			Tax
			TOTAL

I have read and agree with the terms and condition of sale YES

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