Toy Box Storage LLC.
Customer Fax Form
Instructions: To pay your storage fee by fax, print this form, then fill out the appropriate information below. Sections including your credit card payment information need to be filled complete.
Fax payments are to be submitted to 586.775.0567

Note: Fields that are in bold are required.                       Order Date:
Bill To Information
MUST BE CREDIT CARD MAILING ADDRESS
Ship To Information
NOT CREDIT CARD ADDRESS
   - Unit Number:   - Unit Number:
   - First Name:
 
   - First Name:
 
   - Last Name:
 
   - Last Name:
 
   - Email Address:
 
   - Email Address:
 
   - Address:
 
   - Address:
 
   - City:
 
   - City:
 
   - State:
 
   - State:
 
   - Zip Code:
 
   - Zip Code:
 
   - Phone Number:
 
   - Phone Number:
 
   - Fax Number:
 
   - Fax Number:
 
Credit Card
   - Credit Card Circle One:      Master Card   /   Visa  / American Express / Discover
   - Name on Credit Card:
   - Credit Card Number:
   - Billing Zip Code:
   - V-Code on back of card, 3 digit number:
   - Credit Card Expires:
  
   -Signature of card holder:

 
When Completed, Fax To 586.775.0567