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Please be as accurate as possible completing this form. This will help us to narrow equipment choices and provide an accurate quote.

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Account Information









I am looking for:
  • Black & White Copier
  • Black & White Printer


Product Information


(Model(s) you will be replacing - enter "none" if this is a new application)

Features I am Looking for in new Equipment (check all that apply)



Equipment Speed Desired (Pages per Minute)

Approximate Monthly Volume

Paper Sizes


Paper Drawers




Large Paper Supply


Finishing Option


Pricing Option Desired


Additional Requirements or Information