P-TOUCH ACCESSORY ORDER FORM; Accessory Subtotal:; Stock No.- Page 27

Name:
Address:
City:
State/Zip:
Daytime Phone:

SEND ORDER FORM TO:

Brother International Corp.
Attn: Consumer Accessory Div.
P.O. Box 341332
Bartlett, TN38184-1332

Accessory Subtotal:

$

AZ, CA, CO, CT, FL, GA, IL, LA,
MA, MD, MI, MN, MO, NC, NJ,
NV, NY, OH, PA, TN, TX, VA, WA
residents add applicable sales tax

$

Shipping/Handing Options

Please choose one:
• Standard ($5.00)
• 2nd day air freight ($8.75) Mandatory for all

deliveries outside of the continental U.S. (Alaska,
Hawaii, Puerto Rico, Virgin Islands & Canada)

• All other overseas orders ($25.00)

$

TOTAL DUE (US dollars)

$

✂

P-TOUCH ACCESSORY ORDER FORM

Dear Customer:
This order form is provided for your convenience should your retailer not stock the item(s) needed.  To
order by mail, send this completed form along with proper payment to the address below OR credit card
holders: Call toll-free 1-888-879-3232, fax completed order form to 1-800-947-1445, or visit our web
site at http://www.brothermall.com. Please refer to the Accessories listing in your User’s Guide for stock
no. and price.

Method of payment (Check one)

(    ) Visa (    ) MasterCard (    ) Discover (    ) American Express (    ) Check/Money Order
Account Number
Expiration Date
Signature

* Prices subject to change without notice.

Stock No.

Description

Price

Quantity

Total

Subtotal