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Customer No.: ________________ Customer P.O. No.: ________________ Stoelting Order No.: ______________
Sold To: _____________________________________
____________________________________________
____________________________________________
____________________________________________
Contact Name: _______________________________
Phone: ______________________________________
Fax #: ______________________________________
Freight: Collect __________ Prepaid __________ Prepay & Add __________ Account # ________________
Third Party Billing
_____________________________________
_____________________________________
_____________________________________
_____________________________________
Order Comments: Always use original factory replacement parts to assure optimum machine performance. Simply
use this form to order from your distributor. Call 920-894-2293 for Commercial Products to direct you to your local
distributor.
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GENERAL ORDER ADVICE
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Date: __________________________________________
Ship To: ________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Terms of Payment: _______________________________
Requested Routing: ______________________________
FAX or CALL your local distributor.
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