NCR Retail Point of Sale Hardware leader for the past 18+ Years

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Contact Information

Company Name: *

Name: *

Phone: *

Fax:

Email Address:

Street Address:

Street Address Line 2:

City:

State:

Zip:

Shipping Information

Street Address:

Street Address Line 2:

City:

State:

Zip:

Company PO #:

Postal Office Acct #:

Shipping Acct # (FedEx, UPS, DHL):

Express Mail Acct #:

Capital Computer Contact:

Items being shipped for repair

Qty:

Model/Part Number:

Description:

Qty 2:

Model/Part Number 2:

Description 2:

Qty 3:

Model/Part Number 3:

Description 3:

Qty 4:

Model/Part Number 4:

Description 4:

Qty 5:

Model/Part Number 5:

Description 5:

Qty 6:

Description 6:

Model/Part Number 6:

Qty 7 :

Model/Part Number 7:

Description 7:

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CapitalComputerGroup

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