12650 Directors Dr., Suite 500
Stafford, TX 77477                                                         Date_________________

phone:1.800.852.8463
or
1.281.565.8463                                                                   

fax: 281.565.8467                                                                                               Wholesale #__________________

DTS Wholesale Form

 

Contact Name ________________________________________________________

 

Wholesale Acct. _______________________________________________________

 

Address ____________________________________________________________

                                                         

City,State,Zip _________________________________Phone:_______________________                                                                

Method of Payment       ___ Visa  ___ Mastercard  ___ Discover  ___ Am Express

                                   

                        Card #______________________________________________ Exp. Date________

                                                                                   

                                    ____Check #____________   

                                                                                                Shipment Method:________________

Item #

Qty

Description

Price Each

Total Price

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Postage & Handling Charges:                                                 Merchandise Total _________________

Inside the USA, Shipped Ground

orders under $26.00 add $6.00                                   CA Residents add 7.75% _________________

$26.01 – $60.00 add $7.00                                                                            
$60.01 – $100.00 add $8.00                                             
Wholesale Discount _________________

$100.01 – $150.00 add $11.00
$150.01 – $200.00 add $13.00                                                                      
Postage   _________________
$200.01 and over add $15.00                                                

(Optional- UPS, Fed Ex, or Overnight)                                                     TOTAL __________________