<?xml version="1.0" encoding="UTF-8"?>

<form url="request_copy.php"
 window="_self"
 method="POST"
 fontname="MS Sans Serif"
 width="500"
 height="600"
 bkcolor="0xFFFFFF"
 outlinecolor="0xFFFFFF"
 fontcolor="0x000000"
 themecolor="0xFFFF99"
 fontcolor2="#000000"
 bkcolor2="#FFFFFF"
 includeresults="false"
 emailuser="false"
 reqmessage="One or More Fields are Required"
 autoresponse="">

<hidden
 name="thankyoupage"
 value="http://www.mosdirect.com"
></hidden>

<hidden
 name="mailto"
 value="invoice@mosdirect.com"
></hidden>

<hidden
 name="subject"
 value="Invoice Copy Request"
></hidden>

<textinput
 name="name"
 x="192"
 y="60"
 w="267"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
>
</textinput>

<textinput
 name="company_name"
 x="192"
 y="92"
 w="266"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textinput
 name="phone_number"
 x="192"
 y="124"
 w="266"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
>
</textinput>

<textinput
 name="email_address"
 x="192"
 y="156"
 w="265"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textinput
 name="fax_number"
 x="192"
 y="188"
 w="266"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<checkbox
 name="contact_me"
 x="96"
 y="220"
 w="362"
 h="19"
 label="   Please contact me to discuss other account related issues."
 labelPos="right"
 value="checked"
 fontbold="bold"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></checkbox>

<textarea
 name="requested_forms"
 x="16"
 y="312"
 w="456"
 h="81"
 initvalue=""
 wordwrap="true"
 required="true"
 bkcolor="0xFFFFFF"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></textarea>

<submitbutton
 name="Submit Button 1"
 x="392"
 y="432"
 w="100"
 h="20"
 label="Submit"
 fontname="Arial"
 fontcolor="0x000000"
 fontbold="bold"
  fontsize="12"
></submitbutton>

<label
 name="My Text 1"
 x="4"
 y="-2"
 w="160"
 h="19"
 text="www.mosdirect.com"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="16"
></label>

<label
 name="My Text 2"
 x="4"
 y="18"
 w="159"
 h="16"
 text="Martin's Office Supply, Inc."
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 3"
 x="268"
 y="6"
 w="216"
 h="19"
 text="Invoice Copy Request Form"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="16"
></label>

<label
 name="My Text 4"
 x="96"
 y="62"
 w="83"
 h="16"
 text="Your Name*:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 5"
 x="72"
 y="94"
 w="109"
 h="16"
 text="Company Name:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 6"
 x="40"
 y="126"
 w="141"
 h="16"
 text="Your Phone Number*:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 7"
 x="52"
 y="158"
 w="131"
 h="16"
 text="Your Email Address:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 8"
 x="16"
 y="282"
 w="468"
 h="19"
 text="Please enter requested invoice and/or sales order #'s below*:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="16"
></label>

<label
 name="My Text 9"
 x="16"
 y="398"
 w="410"
 h="14"
 text="Enter numbers separated by commas. EX: 12345, 67890, 1122-3, 4455-6, etc."
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="11"
></label>

<label
 name="My Text 10"
 x="40"
 y="470"
 w="403"
 h="16"
 text="Note: Invoice copies are normally provided within 24-48 hours. "
 fontbold="bold"
  fontname="Arial"
  fontcolor="0xFF0000"
  fontsize="13"
></label>

<label
 name="My Text 11"
 x="28"
 y="494"
 w="440"
 h="16"
 text="Please do not call or request invoice copies at our retail location, as "
 fontbold="bold"
  fontname="Arial"
  fontcolor="0xFF0000"
  fontsize="13"
></label>

<label
 name="My Text 12"
 x="28"
 y="514"
 w="394"
 h="16"
 text="they are now only available from our accounting department."
 fontbold="bold"
  fontname="Arial"
  fontcolor="0xFF0000"
  fontsize="13"
></label>

<label
 name="My Text 13"
 x="64"
 y="190"
 w="119"
 h="16"
 text="Your Fax Number:"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 14"
 x="408"
 y="538"
 w="53"
 h="16"
 text="Thanks!"
 fontbold="bold"
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="13"
></label>

<label
 name="My Text 15"
 x="12"
 y="566"
 w="161"
 h="14"
 text="* Indicates a required  input field."
  fontname="Arial"
  fontcolor="0x000000"
  fontsize="11"
></label>

</form>
