MANUAL ORDER FORM
Please complete this form, Fax/Mail it and order will be processed soon.
220Converters.com 1252A,Remington Road Schaumburg, IL-60173-USA Inquiries: (847) 519-1201 Fax: (847) 519-1270 E-mail:sales@220converters.com
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Unit Price |
Amount |
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10 |
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Sales Tax @ 8.25% For Illinois Customers Only. |
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Shipping Charges |
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Grand Total |
$ | Please Call Us For Shipping Charge Details.
Payment Information
Card Type |
___________________________ |
Card Number |
___________________________ [16 Digit Account No.] |
Expiration Date |
___________________________ |
Card Issuer(bank) name & Phone No. |
___________________________ |
Card Holder Information or Billing Address
Shipping Information
By providing above information, you authorize us to charge on your credit card for above purchase order.
Please see return policy page for our return policy.
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