TOM - Supplies Order Request

Supplies Order Request

Fill out this form so we can process your supplies order. Please allow up to 3 business days for shipping/delivery. To avoid delay, please order as soon as the ink hits 30% low.
Company Name*
Delivery Address*
Machine Brand & Model*
Ex. Xerox AltaLink C8030
Serial No.*
Email*
example@example.com
METER READS

For non Kyocera models or non-Tier color models, please enter 0 on Color Tier 2 and 3.
Black & White/Color*
Color Tier 1*
Color Tier 2*
Color Tier 3*
CURRENT INK LEVELS (%)
Black Toner % Percentage*
Cyan Toner % Percentage*
Magenta Toner % Percentage*
Yellow Toner % Percentage*
UPLOAD IMAGE OR PDF OF CURRENT TONER PERCENTAGE OR SUPPLIES PAGE:*

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UPLOAD IMAGE OR PDF OF CURRENT METER PAGE:*

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LIST DOWN YOUR SUPPLIES REQUESTS:*
NOTE: Please allow up to 3 business days for shipping/delivery. To avoid delay, please order as soon as the ink hits 30% low.
Should be Empty: