24219 Northern Illinois Drive  Channahon, Illinois 60410
Phone: 815.467.7800  Fax: 815.467.7838
www.metalstampinc.com    sales@metalstampinc.com

Order Form     .
Date:
Account #: Quote #:
BILL TO :
Name: Address:
City: State/Prov.:
Zip/Postal: Country:
Contact Name: Email:
Phone: Fax #:
SHIP TO: (if different)
Name: Address:
City: State/Prov.:
Zip/Postal: Country:
Phone: Email:
Drawing Submitted Under Separate Cover via email? Yes No
Format (if Known):
P.O. # Requested Delivery Date:
Line #
Qty
Ordered
Part #
Description
Unit
Price
Total
Price
1
2
3
4
5
6
7
8
Shipping Information
FOB Metal Stamp
Please sent products via:
If other please state:
Payment Options

Terms: All net orders must have approved credit. Click HERE for Credit Application form
How will you be making payment?($U.S. Dollars)
Open account, with approved credit!
Cash in Advance
Credit Card Information
MC/Visa (card on record) or
 Full Name:
Credit Card #:    -  - -  Exp Date:

Additional Information to assist us in your request:

© Copyright 2003 Metalstamp Inc. & Web Centers of America, Inc.