Universal Tool Supply, Inc. (Customer Order Form)

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					Universal Tool Supply, Inc. (Customer Order Form)

P.O. Box 300008, Waterford, MI 48330
Contact: 248.623.6828 voice • 248.623.6829 Fax • Email: sales@utsupply.com

To complete a transaction, we will need the following information:

PLEASE NOTE: This is a user friendly Form. Simply insert or place your cursor next to the item you wish to
complete and type in your information. Once completed, you may print this Form and fax it to: 248.623.6829 or you
may Email this Form to us by Left Clicking on the BLUE link below. All items MARKED with a RED (*) below must
be completed or this order May Not be Processed or Shipped.

Customer Information:                                       Customer Ship to Information:

* Customer P.O.:                                            Customer P.O.: Leave Blank if Same
* Contact Name:                                             Contact Name:
* Company Name:                                             Company Name:
* Address Street:                                           Address Street:
* Address City, State, Zip:                                 Address City, State, Zip:
* Phone Number:                                             Phone Number:
* Fax Number:                                               Fax Number:
* Email Address:                                            Email Address:

Product Order Detail Item #1:                               Product Order Detail Item #2:

* Quantity:                                                 Quantity:
* Part Number:                                              Part Number:
* Product Description:                                      Product Description:

Credit Card Information:

* Type of Credit Card:
* Name as shown on Card:
* Credit Card Number:
* Billing Address:
* Credit Card Expiration Date:
* CVS Code: (Three digit security code on back of Credit Card)

Comments Line #1:

Comments Line #2:

Upon receipt of your order, one of our sales associates will contact you to verify that you actually did in fact place
this order and to answer any questions you may have. All orders will be shipped via UPS Ground unless instructed
otherwise in the Comments section of this form. All terms and conditions that are shown on the Universal Air Tool
web site and in the FAQ’s will apply to this order and any other order placed with Universal Air Tool.

            To Email the Order to Universal Air Tool Supply Simply Click on the Blue Link below.

                                  Email this Form to Universal Tool Supply, Inc.

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