Please print and complete this order form and include it when you return your cartridge for recycling.


Merrimack Laser Recycling
Toner Cartridge Order Form
When returning your empty cartridge, place it and the felt cleaning wand (if applicable) into the original shipping carton with styrofoam packing material (or other well- protected shipping carton) along with completed order form and form of payment.

When ordering items from our stock, simply complete the order form below and fax or call us to place your order.

Mail or ship empties by UPS to:
Merrimack Laser Recycling
15 Ermer Road
Salem, NH 03079
Fax Orders To: 
(603) 893-1355

Bill To:

 Ship To: (IF DIFFERENT)
Company____________________________
Address_____________________________
City___________State________Zip_______
Your Name___________________________
Phone (___)___________________________		 Company____________________________
Address_____________________________
City___________State________Zip_______
Your Name___________________________
Phone (___)___________________________

PART# AND DESCRIPTION

QUANTITY

PRICE EACH

EXTENTION
       
       
       
       
       
       

I Am Your Delivery Area, Please Deliver*

  
Sub Total  

 Shipping & Handling*

  

  Total $

  

COMPLETE APPLICABLE
PAYMENT INFORMATION

 NOTES ON SHIPPING
AND HANDLING
_____Check Enclosed. Amount $_________
_____Bill Me
Charge my ____VISA ____Mastercard____Discover
CARD#______________________________
Expiration Date_______________
Signature____________________________________		 Delivery is Avilable in our local area, please call.
* Shipping and handling is $5.95 per cartridge for 1-5 cartridges.
Free shipping and handling on orders of 6 or more cartridges per order.
C.O.D. orders will incur UPS Charges.