Fillable Printable Document Sales Order - Wisconsin
Fillable Printable Document Sales Order - Wisconsin
Document Sales Order - Wisconsin
Document Sales Order
Ordered By:
Name
Tax-Exempt Local Government (If Payer)
Organization’s Name:
Street Address
State of Wisconsin
Department of Administration
Document Sales and Distribution
4622 University Ave.
Madison, WI 53705-2156
DOA-3330
P. O. Box
City, State and ZIP + 4
Daytime Telephone
( )
E-mail Address
To Order and/or for further Information please call:
(608) 266-3358 or Long Distance: 1-800-DOC SALE
(362-7253)
FAX: (608) 261-8150
Check or Money Order must be made payable to:
WI Department of Administration
Open Monday through Friday, 7:45 am to 4:30 p.m.
Inter-D Address: Document Sales
4622 University Ave
(Madison Area Only)
Stock Number Quantity Description Item Price Total
UDC Building Permit Seals (Single) $33.00
UDC Building Permit Seals (5 Pack) $153.00
UDC Building Permit Seals (10 Pack) $303.00
SBD9494
UDC Building Permit Seals (25 Pack) $753.00
Items above are tax exempt
Non-Taxable Items Subtotal
SBD5823 Wisconsin Uniform Building Permit Application (25 Pack) $7.00
SBD5824 Wisconsin Uniform Building Permit Card (25 Pack) $7.00
SBD6025 Inspection Noncompliance & Final Report (25 Pack) $7.00
SBD6072 Permit to Start Construction (25 Pack) $7.00
SBD10266 Notice of Violation (25 Pack) $17.00
SBD7955 UDC Informational Brochure for Homeowners (25 Pack) $7.00
SBD10115 Commercial Building Code Info. Brochure (25 Pack) $7.00
State Government Customers Only
Subtotal
General Services Billing Information Add 5% state sales tax (WI Residents Only)
Customer Use Code Add 0.5% WI county sales tax (if applicable)
Optional Data Add 0.1% or 0.5% stadium tax (if applicable)
Optional Order Number Add $2.50 Credit Card Processing Fee (if applicable)
Authorized Signature:
Total
Your order is subject to return if there are errors on the order
form and/or an incorrect amount due was submitted. Please
call for assistance at (608) 266-3358.
Credit Card Customers Only
For Office Use Only
Date (mm/dd/ccyy)
CSR
Order No.
Customer No.
Orders by phone are accepted when purchases are
made with VISA or MasterCard
Include credit card account number, signature, and
credit card expiration date.
MasterCard VISA
Approval No.
New Exp. Date
(mm/dd/ccyy)
Credit Card Number
Amount Paid
Expiration Date (mm/dd/ccyy)
Signature
Payment Type CA CH V/MC GSBS FR
This form can be made available in accessible formats to qualified individuals with disabilities. This order form may be reproduced.
