DTI Stain Remover Order Form

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Date

Costco Warehouse Number

Costco Name

State

Phone Number

Manager Last Name

Costco Address

Zip Code

Manager First Name

Title

Email (Separate Multiple Email Addresses With Commas)

Quantity of Stain Remover

1
2
3
4

Upload Pictures of the Stain

Click or drag files to this area to upload. You can upload up to 50 files.

Additional Comments

Total

$0.00

Shipping and Taxes not included in the total