PGA Toner Request Form

1
Request ID
2
Name* This field is required.
First Name
Last Name
3
Company* This field is required.
Please Select
Please Select
Audi Motorcars, Inc.
Autoextreme Performance Inc.
Automaxx Resources Group, Inc.
Carrera M Cafe, Inc.
Euro Autocars, Inc.
PGA Automobile, Inc.
PGA Cars, Inc.
Porsche Motors, Inc.
Top-Grade Petro Products Corp.
4
Department* This field is required.
5
Select Printer Type* This field is required.
Epson LX310
EpsonL100/L200/L300/L400/L500/L1300
Epson L1100/L3100/L3200/L5100
Epson L4100/L6100/L6200
Epson L1300
Epson L15150
Bundy Clock
Brother Typewriter AX10/12/15/20/25
Canon G1000/G2000/G2002/G3000/G4000
Canon Imageclass MF746CX/MF756CX
Canon LBP843CX
Canon MP287
Develop Ineo 164
HP LaserJet M282
HP LaserJet M377/M477
HP LaserJet M775
HP LaserJet M575
HP LaserJet CM3530
HP LaserJet M476
HP LaserJet M475
HP LaserJet M451
HP LaserJet M830
HP LaserJet M525
HP LaserJet M521
HP Ink Tank 300/400/500/600
HP DeskJet 1000/2000/3000/4000/5000
HP OfficeJet 6000/7000
HP OfficeJet Pro 8730
Olympia Typewriter Carrera De Luxe
6
Select Toner Type - M775
BLACK (CE340A)
CYAN (CE341A)
YELLOW (CE342A)
MAGENTA (CE343A)
7
Select Toner Type - Ineo 164
BLACK (TN116)
8
Select Toner Type - M476/M475/M451
BLACK (CE410A)
CYAN (CE411A)
YELLOW (CE412A)
MAGENTA (CE413A)
9
Select Toner Type - M575/CM3530
BLACK (CE400A)
CYAN (CE401A)
YELLOW (CE402A)
MAGENTA (CE403A)
10
Select Toner Type - M282
BLACK (W210A)
CYAN (W211A)
YELLOW (W212A)
MAGENTA (W213A)
11
Select Toner Type - M830
BLACK (CF325X)
12
Select Toner Type - M525/M521
BLACK (CE255A)
13
Select Ribbon Type - Typewriter
RIBBON CARTRIDGE (AX10/12/15/20/25)
14
Select Ribbon Type - Bundy Clock
BLUE (TP-20)
15
Select Ribbon Type - LX310
BLACK (S015632)
16
Select Ink Type - HP Ink Tank 300/400/500/600
BLACK (GT53)
CYAN (GT52)
YELLOW (GT52)
MAGENTA (GT52)
17
Select Ink Type - HP OfficeJet 6000/7000
BLACK (932XL)
CYAN (933XL)
YELLOW (933XL)
MAGENTA (933XL)
18
Select Ink Type - Epson L100/L200/L300/L400/L500/L1300
BLACK (664)
CYAN (664)
YELLOW (664)
MAGENTA (664)
19
Select Ink Type - Epson L1100/L3100/L3200/L5100
BLACK (003)
CYAN (003)
YELLOW (003)
MAGENTA (003)
20
Select Ink Type - Epson L4100/L6100/L6200
BLACK (001)
CYAN (001)
YELLOW (001)
MAGENTA (001)
MAINTENANCE BOX
21
Select Ink Type - HP DeskJet 1000/2000/3000/4000/5000
BLACK (680)
COLOR (680)
22
Select Toner Type - M377/M477
BLACK (CF410A)
CYAN (CF411A)
YELLOW (CF412A)
MAGENTA (CF413A)
23
Select Toner Type - HP OfficeJet Pro 8730
BLACK (955XL)
CYAN (955XL)
YELLOW (955XL)
MAGENTA (955XL)
24
Select Toner Type - Epson L1300
BLACK (664)
CYAN (664)
YELLOW (664)
MAGENTA (664)
25
Select Toner Type - Epson L15150
BLACK (008)
CYAN (008)
YELLOW (008)
MAGENTA (008)
26
Select Toner Type -Canon Imageclass MF746CX/MF756CX
BLACK (069)
CYAN (069)
YELLOW (069))
MAGENTA (069)
27
Select Toner Type -Canon LBP843CX
BLACK (335E)
CYAN (335E)
YELLOW (335E)
MAGENTA (335E)
28
Select Ribbon Type - Olympia Typewriter Carrera De Luxe
Olympia Karbonband C / Carbon Ribbon C 6/810/6000
29
Select Ink Type - Canon PIXMA G1000/G2000/G2002/G3000/G4000
BLACK (790)
CYAN (790)
MAGENTA (790)
YELLOW (790)
30
Select Ink Type - Canon MP287
BLACK (810)
TRICOLOR (811)
31
Signature* This field is required.
Should be Empty: