Cuenta de la Compañía

PAYROLL DEDUCTION ORDER FORM
the original slip-resistant
shoe
30 years and still gripping
KEY CODE
SHOES FOR CREWS® SHIPPING RATES
THE SHOE THAT GRIPS®
Commercial Address
QUICKship (1-3 days)
Quantity
1 Pair
$7.98 per pair
2 Pairs
$6.48 per pair
3+ Pairs
$4.98 per pair
Residential Address
3-5 Business Days
Quantity
1 Pair
$7.98 per pair
2 Pairs
$6.48 per pair
3+ Pairs
$4.98 per pair
Order Form Instructions
• Fill out the Payroll Deduction Form below.
• Include your full name, employee ID, shoe style number,
size, width and quantity.
• Return the COMPLETED form to your Manager.
• Place order by phone: 1.800.523.4448, fax: 1.888.647.4637,
website: shoesforcrews.com or email: [email protected]
• Please be sure to include the KEY CODE.
2nd Day
$12.98 per pair
$10.98 per pair
$8.98 per pair
Next Day
$19.98 per pair
$17.98 per pair
$12.98 per pair
2nd Day
$12.98 per pair
$10.98 per pair
$8.98 per pair
Next Day
$19.98 per pair
$17.98 per pair
$12.98 per pair
We cannot ship to P.O. Boxes. We only ship to street addresses. Alaska and Hawaii, please add
$6.00 per shipment. Puerto Rico, Virgin Islands and all others, call 1.800.523.4448 for shipping rates.
SHOES FOR CREWS® Voluntary Shoe Purchase Agreement
I do hereby authorize the Company to deduct the balance owed on my shoe purchase following the Payroll
Department’s receipt of the Shoes For Crews invoice. If I terminate my position prior to the Shoes For
Crews purchase being paid in full, I authorize the Company to deduct the unpaid balance from my final
paycheck where permitted by law. If the Company is not permitted by law to deduct the unpaid balance
from my final paycheck, I authorize the Company to deduct the next installment payment due. I am aware
my employer reserves the right to recover unpaid balances through the cooperation of applicable state
agencies. I understand it is my responsibility to return shoes to the Shoes For Crews warehouse if a
shoe size change or refund is desired. THIS IS A VOLUNTARY PROGRAM AND IS NOT A CONDITION OF
EMPLOYMENT WITH THE COMPANY. VOID WHERE PROHIBITED.
SHOES FOR CREWS® Acuerdo Voluntario De Compra
Por la presente autorizo a la Compañía a deducir el balance adeudado por mi compra de zapatos al recibir el
Departamento de Nómina la factura de Shoes For Crews. Si mi posición terminara antes de que la compra de Shoes For
Crews fuese pagada en su totalidad, yo autorizo a la Compañía a deducir el balance pendiente de pago de mi cheque
de pago final permitido por la ley. Si no es permitido por la ley que la compania deduzca el balance adeudado de mi
pago final , Yo autorizo a la compania para deducir el proximo pago adeudado de mi cheque final. Estoy consciente de
que mi empleador se reserva el derecho de recuperar el balance pendiente con la cooperación de las agencias estatales
correspondientes. Yo entiendo que es mi responsabilidad devolver los zapatos al almacén de Shoes For Crews si deseo
un cambio de medida o un reembolso. ESTE ES UN PROGRAMA VOLUNTARIO Y NO ES UNA CONDICIÓN DE EMPLEO EN LA
COMPAÑÍA. NULO DONDE PROHIBIDO.
Order Information
Employee’s Name (Nombre del empleado)
Style (Estilo)
Width (Anchura)
Size (Tamaño)
Quantity (Cantidad)
Employee’s Signature (Firma del empleado)
Employee ID (Número de empleado)
Shoe Price
Email Address For Shipment Confirmation
Shipping
See Chart Above
Tax
Add Applicable Sales Tax
for CA, FL, KY & NV
Total
Satisfaction Guaranteed! If you are not pleased with your shoes, return them within 60 days of purchase using
the pre-paid UPS label (valid within the contiguous United States). Select Free Exchange or E-Z Return. For E-Z Returns
we’ll refund the shoe price less a $6.95 per pair processing fee.
Satisfacción Garantizada!
Si usted no está satisfecho con sus zapatos, devuelva los zapatos dentro los 60 días
a partir de la fecha de la compra usando la etiqueta de UPS pre-pagada (válido dentro los estados contiguous de los Estados
Unidos). Seleccione Cambios Gratis o Devoluciones E-Z. Para Devolución E-Z, le reembolsaremos el precio de los zapatos
menos un cargo de procesamiento de $6.95 por par.
—— FOR OFFICE USE ONLY ——
Date (Fecha)
Company Name (Nobre de la compañia)
Acct# (Cuenta)
Unit # (Unidad)
Company Address (Dirección de la compañia)
Unit Manager (Gerente de la unidad)
City (Ciudad)
State (Estado)
Zip Code (Codigo postal)
To Order, Call: 1.800.523.4448 • Fax: 1.888.647.4637 • Online: shoesforcrews.com
Ordene hoy! 1.800.523.4448 • shoesforcrews.com/es
Shoes For Crews • 250 South Australian Ave. • West Palm Beach, FL 33401
082015PAY ver1