Master Card or VISA Number 
Expiration date of credit card:
3 digit security code on back of
card
Zip Code for credit card statement
mailing
Please DO NOT
send charge card number in an e-mail. FAX only.
Signature of credit card
holder below is required for us to accept credit card orders. Thank
you.
Company Identification Number
Required For Customs in Your Country
(if any):
Special billing instructions:
Special labeling, packaging instructions
& IHT* selection (foreign):
*International Harmonized Tariff
Code (IHT)
Does Your Country Ban Soft-Wood Pallets?
Yes No
Does Your Country Require a Certificate
of Origin for AM products, authenticated by a US Chamber of Commerce? Yes
No
Does Your Country Require a valid IMPORT
LICENSE for the products you are ordering? Yes No
If yes, provide license number
here and fax copy of license with this order. Thank
you.
If product is detained
in customs because you lack a required import license,after declaring above
that none is required, you hereby agree to pay charges of altering the addressee
to someone with the required license, and any storage fees accumulated while
waiting for authorization to make this change. If such change is not completed
within 30 days after product arrives in your country, you agree to pay shipping
charges both directions (to you and return to us) along with storage in
customs pending your decision to allow return to us. If product is returned
to us, we will refund product cost minus a 15% restocking charge for products
other than nitrifiers (CF 1100-50x, 1400-50x or 7110-50x), which have a
75% restocking charge), credited against return freight and storage fees
accumulated prior to return to us.
Shipping preferences:
Nitrifiers ship by Federal Express
Next Day or International Priority ONLY
Federal Express SONIC (fastest possible,
potentially same-day, VERY EXPENSIVE - USA only)
Federal Express Next Day Morning (USA and
Canada ONLY)
Federal Express International Priority (Export ONLY)
Federal Express Next Day Afternoon (USA
and Canada ONLY)
Federal Express 2nd Day (USA and Canada
ONLY)
Federal Express 3rd Day Select (USA and
Canada ONLY)
Federal Express Ground (mainland 48 states
USA, Canada and Mexico)
Federal Express International Economy (Export)
R & L Freight (ground, most of the USA)
Pitt-Ohio (ground, certain parts of the
USA)
Yellow Freight Ground (in lower 48 states of USA
and Canada)
DHL-Global Forwarding (better rates for
pallets of product by air or ocean, internationally)
Other freight carrier:or forwarder, please
specify name and USA contact information.
If shipment is to be collect on
your account, then please list your account number with the carrier of your
choice, or other codes necessary for them to know that you have authorized
this shipment. UPS does not accept collect shipments unless the shipper
ALSO has a UPSaccount and Alken-Murray does not, but most freight
carriers do not have this requirement
Your account number with carrier
selected above
Do you need a freight quote before
we process your order? Yes No
Do you need a pro-forma invoice
before we process your order? Yes No
If you need a blanket sales tax
exemption certificate, click HERE, fill in
on-line and FAX with order.
Do you require notification of shipment
tracking number after order is shipped? Yes No
If you want tracking information,
how do you want it sent to you?
If by e-mail, give e-mail address
If by telephone, give telephone
number
If by fax, give fax number
How were you referred to Alken-Murray
products?
- Name of Referring Client
- Name of Referring Client
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