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 |
|
Name |
|
| Company |
|
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| Addr1 |
|
Address |
|
| Addr2 |
|
|
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| City |
|
City |
|
| State |
|
State |
|
Zip |
|
Zip |
|
| Telephone |
|
|
|
| Email |
|
|
|
| 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.
|
