Stechschulte Gas & Oil Company, Inc.

Order Form

Print this form. Fill it out. Then, call us to place your order.
Owosso Area: 989-723-8831   FAX: 989-725-6352


DATE: TERRITORY
MANAGER:
SHIP TO: DATE MATERIALS
REQUIRED:
ATTENTION:
STREET ADDRESS:
CITY, STATE ZIP:
REQUESTED BY: TELEPHONE #:  (        )
BILL LEDGER: CUSTOMER #:
ITEM
NUMBER
DESCRIPTION ORDER
QUANTITY
EACH*
QUANTITY
SHIPPED
UNIT
PRICE
AMOUNT
           
           
           
           
           
           
           
           
           
           
           
           
     * When ordering, "Units Per Package"     
     refers to the number of individual units     
     included in each package.     

     Order Quantity reflects the number of     
     packages you would like to receive.
     
SUBTOTAL
HANDLING
FREIGHT
SALES TAX

TOTAL