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Orders should include the following information:
Bill to:
Buyers Name______________________________________________
Title_____________________________________________________
Company Name____________________________________________
Address__________________________________________________
City_____________________State__________Zip________________
Phone________________________FAX________________________
E-mail____________________________________________________
Ship To: (Street address required for UPS delivery)
Users Name_______________________________________________
Title_____________________________________________________
Company Name____________________________________________
Department________________________________________________
Bldg/Mail Stop_____________________________________________
Street Address_____________________________________________
City___________________State________Zip____________________
Phone_________________________FAX_______________________
E-mail____________________________________________________
Authorized Signature____________________________Date_________
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