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Offer Form



This form should only be used to submit an offer for equipment advertised for sale. Should you wish to contact us with any question, please feel fee to contact us by telephone at (276) 466-2929. For further information, select top "Help" tab.

 

This Form Should Be Used To Submit An Offer To Purchase For Sale Equipment


Name of Person Submitting Offer To Purchase Equipment:

Organization Represented:

Organization Street Address:

Suite Number Or Address 2:

City:


State:

Zip / Postal Code:

Country:

Telephone Number:

Extension:

Facsimile Number:


E-mail Address:

This Offer Is Submitted For:
(If Space Is Insufficient, Submit Separate Offer Schedule)

Equipment Item Number
ATM Model Number
Offer Quantity
Offer Amount Each
Offer Amount Total
(Quantity X Amount)
Equipment Offer Item One
Equipment Offer Item Two
Equipment Offer Item Three
Equipment Offer Item Four
Equipment Offer Item Five
Equipment Offer Item Six

Special Notes:

Yes No I / We have read and agree to all terms as set forth in Equipment Conditions Of Sale as detailed below:



By this offer submission, I certify I am authorized to submit this offer for the organization I represent:
Please Initial:



Thank You for your Offer. Please select to submit:


To reset Form and begin again, choose:
AND:


NOTE: ALL FIELDS ARE REQUIRED

Print Offer Form

Thank You for submitting this Offer To Purchase Equipment









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