550 West Locust Avenue
Fresno, CA 93650
If you have a Color copier or printer, please enter the color meter as well as the black & white meter when submitting this form.
*
First Name
*
Last Name
*
Company
*
Phone Number
(
)
*
Email Address
*
Equipment ID
PLEASE NOTE that meter readings entered here may be used for contract billing purposes. Please ensure accuracy.
*
B/W Meter
Color Meter
Please list the quantity of each of the following:
Black Toner
(each)
Cyan Toner
(each)
Yellow Toner
(each)
Magenta Toner
(each)
Staple Cartridge
(carton)
Waste Toner Bottle
(each)
Fuser Oil
(bottle/cartridge)
Drum Cartridge
(each)
Notes:
*
Required Fields
© 2006 Select Business Systems
