Please print, fill out, and mail in this order form with your personal check, money order or cashier's check. You may call 1-800-887-1882, to place a credit card order over the phone. Sorry, C.O.D's are not accepted.
Mr. Ink Jet, Inc. Mail-In Order Form
Customer Information (Shipping/Billing):
First & Last Name: ________________________________________
Street Address: ________________________________________
City:__________________ State:_____________ Zip: ____________
Phone: ( )_______-________ Alt Phone: ( )_______-_________
Email Address: ___________________________________________
Product Information: (please indicate printer brand name, model number and cartridge number)
example: Epson Stylus Color 980 - Black refill kit for T003011 and Color kit for T005011 ink cartridges
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Subtotal: ___________
Shipping: $3.85 UPS Ground
(free after $50.00) ____
$3.85 USPS Priority Mail (free after
$50.00) ____
$3.00 First Class Mail ____
$12.00
Air Mail Canada _____
Other international shipping call for
quote
Subtotal: _________
Shipping:_______
Texas residents add 8.25% Sales Tax ______
Total: ___________
____ check enclosed
____ charge my credit card
___American Express ____Discover ____MasterCard ____Visa
Credit Card Number:_____________________________________
Expiration Date: _________
Name as it appears on card:______________________________
Customer Signature: ___________________________________