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 E52645
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 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 - M525/M521
BLACK (CE255A)
12
Select Toner Type - E52645
W9008MC BLACK (C)
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: