The Items in RED are mandatory. Name: E-mail: Company: Address: City: Phone:(ex. 123-45-678) Model:

Desired Features:

Copy

Print

Scan

Color scan

Fax

Copy Options:

Stapling

Hole Punch

Output:

B/W

Color

Paper Sizes:

Letter (8 1/2 X 11) Legal (8 1/2 X 14) Ledger (11 X 17) Copy Volume: 1-25 Pages a Day 26-50 Pages a Day 51-100 Pages a Day 101-200 Pages a Day 201 and Up

Decision Time Frame:

1-5 Days 6-14 Days 2 Weeks or More Comments: