Note: Please print this form and fax it to Paramount Computer Corp. at
(512) 263-7018. ** You must submit a credit application
prior to making credit card purchases.
Please complete the signature on file form
before submitting an order.
| Customer Information |
Shipping Information |
| Contact |
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Name |
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| Company |
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| Addr1 |
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Address |
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| Addr2 |
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| City |
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City |
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| State |
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State |
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Zip |
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Zip |
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| Telephone |
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|
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| Email |
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|
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| Tax ID |
|
Terms |
|
| Sales Rep |
|
Your PO |
|
| Method |
|
Account |
|
|
Item |
Description |
Qty
|
Cost |
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*** For additional items please submit an additional form. Be
sure to reference the original order form in the additional information section.
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