ORDER FORM

PRINT THIS FORM AND PHONE, FAX, MAIL, or e-mail

INKWELL STATIONERS, INC.

Suite 500 Allegheny Building ~ 429 Forbes Avenue ~ Pittsburgh, PA 15219

Phone: 412-434-7122 / Fax: 412-434-7133 / e-mail: InkwellStationers@gmail.com

NAME: ________________________________________________________________________

STREET ADDRESS: ______________________________________________________________

CITY: _________________________________________________________________________

STATE: ____________ ZIP CODE: _____________ PHONE: (________)____________________

ITEM / FORM NUMBER

QUANTITY

PRICE

    $
     
     
     

SUBTOTAL:

$

SHIPPING & HANDLING: [Divorce Forms are $3.74 Plus Tax]

All other Products/Forms: ( $8.00 for orders up to $25.00; $8.50 for orders $25.01-$50.00;

$9.40 for orders $50.01-$75.00; $10.90 for orders $75.01-$100.00; Over $100.00 please call)

$
7% SALES TAX (IN PA.): $
TOTAL: $
Money Order enclosed (No Checks) : $ ______________________________________________
Charge Card (Visa, Mastercard, American Express)

(For Visa &Mastercard, please give the 3 digit "V" number found in the signature part on the back of your card - The last 3 numbers_______):

#: ___________________________ Expiration Date: _______ Signature: ______________________

PLEASE INCLUDE PAYMENT WITH YOUR ORDER. NO REFUNDS ON LEGAL DOCUMENTS OR CUSTOM-MADE ORDERS PRICES AND FORMS ARE SUBJECT TO CHANGE WITHOUT NOTICE

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Last Updated JAN 11, 2015 by CAL