Fax Order Form

Hughes Display Group, Inc.
Display Case Showcase
Toll Free Phone: 800.790-5733
Toll Free Fax Order Line: 866-829-0721
Email: Sales@display-case-showcase.com


Fax Order Form (Please print this form and complete all necessary sections)

To: Hughes Display Group / DCS	Date:	_____________________________
Toll Free Fax: 866-829-0721	Sender:	_____________________________
Attn: Online Sales	Organization:	_____________________________
	Phone:	_____________________________
	Fax:	_____________________________

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Online Order	Quote Request	Info Request	Other
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please provide the following required information:

Full Name:	________________________________________________________
Street Address:	________________________________________________________
Address 2:	________________________________________________________
Please indicate if the address you have provided is a residence address. YES NO (circle one)
City:	________________________________________________________
State/Province:	_____________________________
Zip/Postal Code:	_____________________________
Contact Name:	_____________________________
Day Phone:	(_____) ______________________
Email Address:	________________________________________________________

Model #	Description	Qty	Price Ea.	Total Price












SUBTOTAL:				$
SHADED AREA FOR INTERNAL USE ONLY - DO NOT COMPLETE (We will calculate appropriate shipping, freight and AL tax, when applicable, and notify you of the total cost of your order.)
Shipping/Freight:
FL Tax (if applicable)
TOTAL:				$

Please review your order prior to faxing to insure the accuracy of the information you have provided.

Upon receipt of your completed fax order form, we will contact you at the day time phone number given above to:

Confirm your order and advise you of product availability;
Answer any questions you may have;
Arrange for payment and shipment of your order.
Fax orders must be signed by a person authorized to make such requisitions either individually or acting on behalf of a company or organization.
Please read our Terms of Sale and Damaged Merchandise Return Policy. Your signature below indicates that you have read and understand both and, that by your signature below, you are deemed to have agreed to adhere to said policies.

If you are interested in obtaining a quote or other information, please enter your request here:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

I understand that I must inspect my order immediately upon receipt and notify Display Case Showcase, within 24 hours of delivery, of any damages or shortages.

______________________________________
Authorized By Signature

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This fax communication is intended only for the use of the addressee and may contain information which is privileged and confidential. Please notify sender immediately if you are not the intended recipient.