TARKSOL SAMPLE REQUEST

As a result of the tremendous interest and demand regarding sample requests, the following sample pricing has been put into effect.

Samples are available in pints, quarts, gallons and 5 gal pails.

Sample Charge

For a sample, please complete the information below and fax or e-mail for processing.

Account Name:________________________________________________________________

Complete Address:_____________________________________________________________

                              _____________________________________________________________

Attention:_____________________________________________________________________

Telephone No:_________________________________________________________________

Fax No:_______________________________________________________________________

E-Mail Address:________________________________________________________________

Sample Requested and size:_____________________________________________________

UPS, Fed Ex, DHL Account No.___________________________________________________

Billing Information:

Credit Card:  Credit Cards are not accepted

            Account Name, Account Number, Expiration Date, Mailing Zip Code

Invoice Company;

            PO Required with PO Number, Sample, and Sample and Sample Size