WBA Account Titling Handbook Order Form

*Required Field

FIPCO Customer #:
* Institution Name:
Contact Name:
Address:
City:
State:
Zip Code:
County:
* Business Phone:
Fax:
Email:
Handbook Pricing:	$175.00 each (WBA Member) $295.00 each (non-WBA Member) Quantity :
$ for quantity :	$
Shipping & Handling	$ 6.00
Subtotal (for sales tax purposes)	$
5.5% (0.05) Wisconsin Sales Tax	$
.5% (0.005) County Sales Tax (If appies)	$
.5% (0.005) Brown County Stadium Tax (If applies)	$
.1% Stadium Tax(0.001) (Milwaukee, Ozaukee, Racine, Washington and Waukesha Counties)	$

Total Payable to FIPCO	$

Thank you for your order!