Fax/Mail Order Form

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Address:
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  State:    Zip:
Country:
  Email: 
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**Fill your order below:**
For Printer Model	Cartridge type	Qty	Price




MINNESOTA Residents add 6.5% sales tax:
Shipping charge is $4.99 for all orders below $75: Priority mail charges are $6.99.
TOTAL:

Payment Type: Check Credit Card

Credit card Information:
Credit card type:		Credit card #:
Name on the card:		Expiry date:
(3 or 4 digit code from back or front of card)		CCV:

Mail your order to:

Performix LLC
4905 W. 84th Street
Bloomington, MN 55437 USA Fax: 952 400-8008

Email : admin@bestinsupplies.com
Tel: 952 893-0143 (Twin Cities, Minnesota region)
Toll free: 1-877-453-3640

Please enter any other additional request/suggestion:


Performix LLC 4905 W. 84th Street Bloomington, MN 55437 USA	Fax: 952 400-8008