Stock No.; ACCESSORY ORDER FORM- Page 76

ACCESSORY ORDER FORM

This order form is provided for your convenience should your retailer not stock the item(s)
needed or if you prefer to order by telephone. To order by phone, please call Brother Interna-
tional at 1-800-668-2768 and have your Visa or MasterCard available.

Prices subject to change without notice.

Before calling:
1. Review the reverse side of this form and select the desired items.
2. Complete the order form, indicating the quantity of each item (for your records).
3. Enter the total on the “Supply/Accessory Total” line below (for your records).
4. Add appropriate sales tax and shipping/handling costs (for your records).
5. Have your Visa or MasterCard number and expiration date available.

G.S.T. # R100663764
P.S.T. # 100100117TQ0001
* Prices subject to change without notice.

Stock No.

Description

Price

Quantity

Total

TOTAL

Supply/Accessory Total

$

All Residents of Canada: Please add 
applicable sales taxes (G.S.T. & P.S.T.).

G.S.T $
P.S.T.

$

Shipping/Handling

$5.00

TOTAL DUE

$

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