Albuquerque Customer Service

All service requests and orders will be confirmed by telephone before processing.

REQUESTED BY:
NDC Customer #:
First Name:
Last Name:
Store:	Store#:
Address:

TELEPHONE NUMBER FOR CONFIRMATION:
ORDER OR REQUEST:

NDC item#	Description	Size	Cases	Bottles

Instruction Line:

1. Instructions can be entered without an order.

2. Instructions can be changed or entered directly in the block below.