Panelsource Control Panel Order Form

Existing accounts complete the form below. If you do not have an account, please see our Doing Business page for steps to establish an account, or contact us at (386) 274-2079.

Questions on how to configure a Panelsource part number, see How To Order. Need to order a P6 Series Annunciator panel, see the P6 Series page.

Note: It is the client's responsibility to select the proper equipment and specify the proper configuration to meet the specific job requirements. Orders submitted will be acknowledged via fax to your fax number on file with us. Standard terms of sale apply and are attached to our order acknowledgements and invoices.

Your Name:
Account number: (found on any of our invoices, packing slips or order acknowledgements):
Company Name:
City:
State/Province:
Telephone:
Fax:
E-mail address:
Purchase Order Number (required):
Ship to:

City, State/Province, Zip:	,,
Country:
Ship Method:
Notes:	if ordering more than one model, submit each model and press "Back" on your browser to submit subsequent models.

Specify configuration and options:

Quantity	Model	Voltage (L-L)	Amperage	# of phases/Frequency	Engine Start Motor Voltage (DC Voltage)

Additional Options:

Once your order is submitted and processed, a faxed acknowledgement will be generated and sent to the fax number on record on your account. This acknowledgement is sent within 12 hours of order placement. Typical shipment time for Panelsource products is 5-10 days.