ORDER FORM
You may submit this form by fax, by email, by postal mail, or by
phone.
WaterFilters.NET, LLC
5448 Apex Peakway • Apex • NC • 27502-3924 US
Phone #: 612-605-6910 • Toll-Free #: 1-888-801-7873 • Fax #: 888-959-2226
CustomerService@waterfilters.net •
www.WaterFilters.NET
BILLING ADDRESS AND SHIPPING ADDRESS:
Name: _________________________________________________________
Company Name (if applicable): ______________________________________
Billing Address (Must match credit card Billing Address):
Street 1:_______________________________________________________________
Street 2:_______________________________________________________________
City:________________________________________ State:________ ZIP:_____________
Phone Number: ___________________ Fax Number: ____________________
Email Address: ___________________________________________________
Shipping
Name & Address (If different than Billing Address above):
Street 1:_______________________________________________________________
Street 2:_______________________________________________________________
City:________________________________________ State:________ ZIP:_____________
Phone Number: ___________________ Fax Number: ____________________
PRODUCT ORDER (Attach another sheet if necessary):
Product Code _________________
Product Price $_______________ x Quantity _______ = Amount $__________
Product Code _________________
Product Price $_______________ x Quantity _______ = Amount $__________
Product Code _________________
Product Price $_______________ x Quantity _______ = Amount $__________
Product Code _________________
Product Price $_______________ x Quantity _______ = Amount $__________
Product Code _________________
Product Price $_______________ x Quantity _______ = Amount $__________
Product Code _________________
Product Price $_______________ x Quantity _______ = Amount $__________
Shipping Cost: _______________________________________________________
USA Shipments: Enter preferred method of shipment
(UPS Ground, UPS Next Day Air, UPS 2nd Day Air, UPS 3 Day Select, USPS Priority Mail).
International Shipments: Enter preferred method of shipment (USPS Global
Express Mail).
Shipping charges are actual shipping costs based on weight and destination. Please expect Next-Day
Air, 2nd Day Air, and 3-Day Select to ship on the next business day (M-F) following your order or
when your check or money order clears. For shipping costs, email shipping address and order contents to
CustomerService@waterfilters.net
or call 888.801.7873. You can also use the "Shipping Estimator" on our
website.
Shipping Cost: $________________
Subtotal: __________________________________________________________
Sales Tax (6.875% MN only): ____________________________________________
Total Amount: _____________________________________________________
PAYMENT METHODS (Choose one of the three options):
1) Name on Credit Card: ____________________________________________
Credit Card Type (circle one): MasterCard Visa
Discover American Express
Credit Card Number: _______________________________________________
Expiration Date: __________________ Credit card verification number*: _______
2) Check #: _______________________
3) Money Order #: __________________
THIS TRANSMISSION CONTAINS CONFIDENTIAL
INFORMATION INTENDED FOR USE
ONLY BY THE ABOVE MENTIONED RECIPIENT. READING, DISCUSSION, OR COPYING OF
THIS MESSAGE IS STRICTLY PROHIBITED BY ANYONE OTHER THAN THE NAMED
RECIPIENT, OR HIS OR HER EMPLOYEES OR AGENTS. IF YOU HAVE RECEIVED THIS
DOCUMENT IN ERROR, PLEASE NOTIFY US BY TELEPHONE (COLLECT), AND RETURN
TO US AT THE ABOVE ADDRESS VIA THE U.S. POSTAL SERVICE.
*What is a Credit Card Verification Number?
Credit card verification numbers enable an important security feature
for credit card transactions on the Internet and over the phone. A credit
card verification number (CVV2) is the three- or four-digit number printed
in the signature space on the back of most credit cards and on the front of
American Express cards, like this:
Some newer credit cards only show the last four digits of the credit
card
number on the back, followed by the CVV2 number.
The CVV2 number enhances fraud protection and helps to validate two things: