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Instructions
Print this form, then fill in your address and payment information in the space
provided and fax or mail it to us at:
Freund Container & Supply
A Division of Berlin Packaging
4200 Commerce Court, Suite 206
Lisle, IL 60532
PURCHASE ORDER FORM FOR DATE: 11/22/2008
Freund Container
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BILL TO: SHIP TO:
____________________________________ ____________________________________
Name Name
____________________________________ ____________________________________
Company Company
____________________________________ ____________________________________
Street Address Street Address (Do not use a PO Box)
____________________________________ ____________________________________
Street Address (line 2) Street Address (line 2)
____________________________________ ____________________________________
Street Address (line 3) Street Address (line 3)
____________________________________ ____________________________________
City State ZIP City State ZIP
____________________________________ ____________________________________
Country Country
____________________________________ ____________________________________
Phone Ext. Phone Ext.
____________________________________ ____________________________________
Fax Fax
____________________________________ ____________________________________
E-mail E-mail
PAYMENT:
_____ Check Enclosed: $_________________ (Make Payable to Freund Container)
_____ Credit Card: ___VISA ___MasterCard ___American Express
Credit Card Number: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Card Security Code: ________________
Expiration Date: ____/____
Name on Card: ________________________________________________________
Signature: ___________________________________________________________
Shipping Method (if other than Standard): ___2-Day ___Next Day
THANK YOU FOR ORDERING FROM FREUND CONTAINER
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