Sortimo Quick order form

• Customer Order No.

• SAP debitor number:

• Client name

• Email:

• Telephone number

• Order taken by

• Customer preferred delivery date:

  Date

• Remarks:

ORDER FORM

• Order for:

  Select Quick quote Mobile assortments Accessories OEM blocks CarMo Simpleco Px5 design

  • Quick quote
  • Mobile assortments
  • Accessories
  • OEM blocks
  • CarMo
  • Simpleco
  • Px5 design

• See our brochures for more ideas
  http://www.sortimo.co.uk/Catalogues.1753.0.html

• Article describtion and quantities

• Take a picture from article if no article number at hand

  Media

• Total order volume (net) and incl VAT :

• Sortimo terms and condition
  http://www.sortimo.co.uk/GTCT.37.0.html?&no_cache=1&cid=2377&did=2559&sechash=431494ab

• I do agree on Sortimo terms and conditions and read them as they are linked above.

  Yes

  No

• Payment by

  Credit card

  Invoice

  Cash

• Card holder:

• Card number:

• Valid thru

• 3-digit confirmation number

• Enter billing address

• Or search by map
  Address

• Shipping is billing address?

  Yes

  No

• Enter shipping address if other than billing address

• Or search by map
  Address

• I herewith place an order for above mentioned products. I agree furthermore to debit my credit card with details as stated above if credit card was my preferred payment method.

  Sign

• Do you agree to reveive emails and newsletter notification from Sortimo Intl?

  Yes

  No