BatterySpec.com Order Form

Order Form

Billing Information

Customer Name:Business Name:
Purchase Order #Today's Date
Customer Address:
City:State:Zip:
Phone:
Email Address:

Shipping Information

Customer Name:Business Name:
C/O:
Customer Address:
City:State:Zip:
Phone:Fax:

Payment Method

Credit CardVisaMasterCardAMEXDiscover
Card NumberCard Verification #(what is this)
Exp. Date

QTY.	Part Number	Product Description	Unit Price	Total

Shipping Charge

Total Charge

ATTENTION RESELLERS:
If you are purchasing for resale, please type “FOR RESALE” in the Order Notes section.
If you would like us to drop ship your order, Please be sure to type “Drop Ship” in the same section.
If you have not submitted a General Resale Certificate (BOE-230), please fax it to us @ 408-494-0804. Thank you.
Order Notes