Current Equipment Supplier: *
—Please choose an option—Our CompanyBrotherCanonCopystarEpsonHPKIPKonica MinoltaKyoceraLanierLexmarkMuratecOceOKIRicohRisoSamsungSavinSharpSindohToshibaXeroxOtherWe Currently Don't Have Any Equipment

Approximate current lease term expiration date: *
Black & White – Copy & Print Volume Per Month: *—Please choose an option—01-3,0003,000 – 10,00010,000 – 20,00020,000 – 35,00035,000 – 50,000Over 50,000I'm not sure – I need an assessment
Where do you currently purchase your printer cartridges?
Do you know who your sales representative is with our company? *  YesNo
If so, please enter your Sales Representative’s Name: