ORDER FAX FORM

Order By Fax
Print this page, Fill in the information and fax to: 973-689-9595
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Ship To:	Bill To (If Different From Ship To)
First Name:___________________________	First Name:____________________________
Last Name:___________________________	Last Name:____________________________
Address:_____________________________	Address:______________________________
____________________________________	_____________________________________
City:________________________________	City:_________________________________
State:_____________ ZIP:______________	State:_____________ ZIP:_______________
Phone: ______________________________	Phone:________________________________
Email:_______________________________	Email:_________________________________

Item Model	Qty	Item Description	Finishes	Price Each	Total Price




SHP		Shipping - See instructions below
Sub-Total
NJ TAX		New Jersey Sales Tax (add 7.0%)
Total Order

Shipping Info
*Cost of shipping is calculated using your zip code, the weight and size of the item(s). The best way to find out your shipping total is to add the item(s) to your shopping cart on our site. It will then calculate your shipping total before you finalize your order total. Please use this shipping amount when placing your order via fax.
If you have any problems calculating shipping please send us email at sales@saveonfaucet.com

Credit Card Information

Circle One: MasterCard Visa Amex Discover

Card Number:_____________________________

Exp Date:_________________________________

Verification Number:______________________

Signature: _______________________________

Date: ____________________________________