P-TOUCH ACCESSORY ORDER FORM (For USA Only)
Dear Customer:
This order form is provided for your convenience should your retailer not stock the item(s)
needed. To order by mail, send this completed form along with proper payment to the address
below OR credit card holders: call toll-free 1-888-879-3232, fax completed order form to
1-800-947-1445, or visit our web site at http://www.brothermall.com. Please refer to the
Stock #
Accessories listing in your User's Guide for stock no. and price.
Description Quantity Price
To complete the Order Form:
1. Select the desired items.
(See ACCESSORIES.)
2. Complete the form above, indicating the
quantity of each item.
3. Total the columns and enter the total on the
"Supply/Accessory Subtotal" line.
4. Add the appropriate Sales Tax and Shipping/
Handling Charge.
5. Clearly print your name and address in the
space below.
6. Place your order
a. Call toll free anytime 1-888-879-3232
b. Order on line at www.brot
c. Fax completed form to 1-800-947-1445
payment to
BROTHER INTERNATIONAL CORP.
Attn: Consumer Accessory Div.
P.O.Box 341332
Bartlett, TN 38184-1332
Supply / Accessory Subtotal: $
AZ, CA, CO, CT, FL, GA, IL, LA,
MA, MD, MI, MN, MO, NC, NJ,
NV, NY, OH, PA, TN, TX, VA, WA, WI
residents add applicable sales tax: $
Shipping and Handling Options $
Please choose one:
Standard Freight:
Continental U.S. ($5.75)
Alaska and Hawaii ($8.75)
GU, PR, VI ($15.75)
2nd Day Air Freight
(Continental U.S. only): $8.75
Overnight Delivery
(Continental U.S. only): $14.75
TOTAL DUE $
No C.O.D. orders
Method of Payment (check one)
Name:
( ) Visa ( ) Master Card ( ) Discover
Address:
( ) Check/Money Order ( ) American Express
City:
State: Account Number
Zip: Expiration Date
Daytime Phone #: Signature
Daytime Fax #:
Billing Address (if different from shipping address at left)
Email:
Your Model Number:
Prices subject to change without notice.All prices quoted in US Dollars.
d. Mail completed
leted form along with proper
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