Reseller Support
Purchase Order Form (use this form only if you do not have your own)
     
Please fill in all the fields.

Order Number:

Date

Customer PO#

If you do not have a PO numbering system, enter the date (MM/DD/YYYY) in the field above.

Company Information

Bill To:
Company Name

Address


City

State

Zip Code

Ship To:
Company Name

Address


City

State

Zip Code


Order placed by

Phone Number

Ship Via:

F.O.B

Terms


Products
Choose your products from the drop down list, enter units, price, extended price and Total.

Enter the unit price from the price list provided to you from your Benwin Sales Representative.
If you don't know the price, call Benwin at 1-888-9BENWIN or email  sales@benwin.com

Item No. Units Price Extended
Total:

Authorization Signature _______________________________________
Be sure to sign above

Print this page using the browser print button, then fax it to Benwin at 626-935-8891.
Thanks!

Back to reseller home page here.