PLEASE PRINT and MAIL TO:    
Instant-Screen.com
55648 Silver Creek Lane, Macomb Twp .Mi. 48042
Phone 810-397-0301 Fax 586-461-0106
Step 1. SOLD TO
Name  
Company
 
Address 1
 
Address 2
 
City
 
State
  Zip Code  
Phone
           
email address  
@
 
Step 2. SHIP TO _______ Same as Sold To
Name  
Company
 
Address 1
 
Address 2
 
City
 
State
  Zip Code  
Phone
           
email address  
@
 
Step 3. Special shipping instructions
 
 
Step 4. PRODUCT SELECTION
  Stock # Item Description Price
 
Qty   item-total
   
 
 
x
  = $
     
 
x
  = $
   
 
 
x
  = $
     
 
x
  = $
   
 
 
x
  = $
     
 
x
  = $
   
 
 
x
  = $
     
 
x
  = $
   
 
 
x
  = $
     
 
x
  = $
   
 
 
x
  = $
     
 
x
  = $
Please add the Qty and Item total columns and write here ==>
 
    $
if Michigan resident, Please compute sales taxt at 6.0% (multiply subtotal by .06) ==>
 
First item shipping and handling(S & H)==>
 
$7.95
Add'l items (S & H) $5.95ea - $5.95 multipy (QTY - 1) ==>
  =  
Grand Total (item totals +tax +S & H) - Add last column and enter here ==>
 
Step 5. METHOD of PAYMENT checks, money orders only - for credit see web site - www.instant-screen.com
check #   TOTAL (US. $)   Signature   date      
F & P Form 115 (rev 4) code xxxxx-xxx
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