The Inkwell Shipping Request Form
Virgin Cartridges only (never remanufactured) Must be brand name (i.e. HP for HP printers, Lexmark for Lexmark printers, etc.), DO NOT SEND "Compatibles" such as Korectype, Northern Laser, Northern Image, Laser Networks, Kroy, Diaspron, Ikon, Multilaser, etc. Please DO NOT send cartridges not listed here or on the Eligible Cartridge Listing. (there is a $1 handling charge deducted from your payment for every laser cartridge sent in which is not on these lists) Cartridges listed as $ 0.00 can be shipped but have no value. Prices paid are in CDN $ and are subject to change without notice.
Customer Information Organization: Address: City:   Province:   Postal Code: Phone: Fax: Email: Make cheque payable to:
Brother   Laser   Qty Code Description Value   DR250 DR250 $0.25   DR350 DR350 $2.00   DR400 DR400 $0.50   DR500 DR500 $1.00   DR510 DR510 $2.00   DR520 DR520 $1.00   TN350 TN350 $1.00   TN530/560/660/670 TN530/560/660/670 $0.00   TN540/550/570580 TN540/550/570/580 $1.00 Canon   Inkjet   Qty Code Description Value   BC-01 BC-01 $0.00   BC-02 BC-02 $0.10   BC-05 BC-05 $0.25   BC-20 BC-20 $0.00   BX-2 BX-2 $0.10   BX-3 BX-3 $1.00   CL-31 Colour CL-31 Colour $0.10   CL-41 CL-41 $0.50   CL-51 CL-51 $0.75   CL-52 CL-52 $0.00   PG-30 Black PG-30 Black $0.00   PG-40 PG-40 $1.00   PG-50 PG-50 $1.00     Laser   Qty Code Description Value   0264B001AA #106 $1.00   E16/20/31/40 E16/20/31/40 $1.00   FX-3 FX-3 $0.00   L50 L50 $0.00   S35 S35 $0.00   X25 X25 $1.00 Dell   Inkjet   Qty Code Description Value   7Y743 Black 7Y743 Black $0.00   7Y745 Colour 7Y745 Colour $0.10   A920 Black (T0529) A920 Black (T0529) $0.10   A920 Colour (T0530) A920 Colour (T0530) $1.00   M4640 Black M4640 Black $1.00   M4646 Colour M4646 Colour $1.00   T0601 Black T0601 Black $0.25   T0602 Colour T0602 Colour $0.25     Laser   Qty Code Description Value   1100 1100 $0.25   1500 (7Y608) 1500 (7Y608) $0.10   1600n 1600n $0.00   1700 1700 $0.10   1815 DN 1815 DN $1.00   5210 5210 $1.00   5310 5310 $1.00   M5200 M5200 $1.00   ML 1610 ML 1610 $1.00   ML 2010 ML 2010 $1.00   S2500 S2500 $2.00   W5300 W5300 $1.00 Hewlett Packard   Colour Laser   Qty Code Description Value   Q5950A Series 4700 Black $1.50   Q5951A Series 4700 Cyan $1.50   Q5952A Series 4700 Yellow $1.50   Q5953A Series 4700 Magenta $1.50   Q6000A Series 2600 Black $0.10   Q6001A Series 2600 Cyan $1.00   Q6002A Series 2600 Yellow $1.00   Q6003A Series 2600 Magenta $1.00   Q6460A Series 4730 Black $1.00   Q6461A Series 4730 Cyan $1.50   Q6462A Series 4730 Yellow $1.50   Q6463A Series 4730 Magenta $1.50   Q6470A Series 3600 Black $0.00   Q6471A Series 3600 Cyan $1.00   Q6472A Series 3600 Yellow $1.00   Q6473A Series 3600 Magenta $1.00   Q7560A Series 3000 Black $1.00   Q7561A Series 3000 Cyan $1.00   Q7562A Series 3000 Yellow $1.00   Q7563A Series 3000 Magenta $1.00     Inkjet   Qty Code Description Value   100 C9368 A $0.00   130 8767 H $0.10   131 8765 H $0.10   134 9363 H $0.10   135 8766 H $0.00   138 9369 H $0.10   15 C6615A or D $0.10   17 C6625A $0.10   19 C6628 A $0.00   20 C6614 A or D $0.50   21 C9351 A black $0.10   22 C9352 A $0.10   23 C1823 A,D, or G $0.00   26 51626A or D $0.00   27 C8727 A $0.10   28 C8728 A $0.10   338 8765 E $0.10   339 8767 E $0.10   343 8766 E $0.10   344 9363 E $0.10   348 9369 E $0.10   45 51645 A or G $0.10   56 C6656 A $0.10   57 C6657 A $0.50   58 C6658 A $0.00   59 C9359 A $0.10   78 C6578 A or D $0.50   80 C4893A $0.10   852 8765 Z $0.00   853 8767 Z $0.00   855 8766 Z $0.10   857 9363 Z $0.10   858 9369Z $0.10   92 C9362 W $0.00   93 C9361 W $0.00   94 8765 W $0.10   95 8766 W $0.10   96 8767 W $0.00   97 9363 W $0.00   98 C9364 W $0.10   99 9369 W $0.10     Laser   Qty Code Description Value   03A C3903A $0.25   09A C3909A $2.00   09X C3909X $2.00   11X Q6511X (HP 2420/2430) $1.00   12A Q2612A (HP 1010/1012/1015) $0.75   16A HP 5200 (Q7516A) $2.00   27X C4127X (HP 4000) $0.00   29X C4129X (HP5000) $0.25   38A Q1338A (HP 4200) $0.10   42X Q5942X (HP 4250/4350) $0.10   43X C8543X (HP 9000) $0.50   45X Q5945X (HP 4345) $0.10   49X Q5949X (HP1160) $0.10   51 A or X Series P3005/M3035 (Q7551A or Q7551X) $1.00   53 A or X Series LJP2015 (Q7553A) (Q7553X) $1.00   91A or X 92291A or X (HP 3si) $0.10   92A C4092A (HP 1100) $0.10 IBM   Laser   Qty Code Description Value   113R173 N24/32/40 $2.00   1145 1145 $1.00   1222 1222 $1.00   1422 1422 $5.00   63H2401 4317 $0.25   63H3005 4312 $0.50   75P4300/01/03/04/05 1332/1352/1372 $0.50   75P5710 1412 $1.00   75P6959 1532/1552/1572 $0.50 Lexmark   Inkjet   Qty Code Description Value   1 18C0781 $0.10   13400HC 13400HC black $0.10   16 10N0016 black $0.50   17 10N0217 black $0.25   19 19 colour $0.00   20 15M0120 $0.00   25 15M0125 $0.00   26 10N0026 colour $0.50   27 10N0227 colour $0.00   31 18C0031 Photo $0.00   32 black 18C0032 $0.10   33 colour 18C0033 $0.10   34 black 18C0034 $0.10   35 colour 18C0035 $0.10   48 48 black $0.50   50 17G0050 black $0.10   55 17G0055 black $0.10   60 17G0060 colour $0.00   65 17G0065 colour $0.00   70 12A1970 $0.10   75 12A1975 $0.10   80 12A1980 colour $0.00   82 18L0032 black $0.10   83 18L0042 colour $0.10   85 12A1985 colour $0.00   88 18L0000 $0.10   90 12A1990 photo $0.00   95 12A1995 photo $0.00     Laser   Qty Code Description Value   08A0475 E320/E322 $1.00   08A0476 E320/E322 $1.00   08A0477 E320/E322 $1.00   08A0478 E320/E322 $1.00   10S0150 E210 $0.00   12015SA E120 $0.10   12035SA E120 $0.10   12A0725 Optra Se $5.00   12A0825 Optra Se $5.00   12A2202 Optra E310 $0.25   12A5740 Optra T61X* $2.00   12A5745 Optra T61X* $2.00   12A5840 Optra T61X* $2.00   12A5845 Optra T61X* $2.00   12A6730 Optra T520 $1.00   12A6735 Optra T520 $1.00   12A6760 Optra T620 $1.00   12A6765 Optra T620 $1.00   12A6830 Optra T520 $1.00   12A6835 Optra T520 $1.00   12A6860 Optra T620 $1.00   12A6865 Optra T620 $1.00   12A7300 E321, E323 $1.00   12A7305 E321, E323 $1.00   12A7310 Optra T420, T422 $0.50   12A7315 Optra T420, T422 $0.50   12A7360 Optra T630, 632, 634 $1.00   12A7362 Optra T630, 632, 634 $1.00   12A7365 Optra T630, 632, 634 $1.00   12A7400 E321, E323 $1.00   12A7405 E321, E323 $1.00   12A7410 Optra T420, T422 $0.50   12A7415 Optra T420, T422 $0.50   12A7460 Optra T630, 632, 634 $1.00   12A7462 Optra T630, 632, 634 $1.00   12A7465 Optra T630, 632, 634 $1.00   12A8400 E230, E232, E330, E332 $0.50   12A8405 E230, E232, E330, E332 $0.50   12A8420 Optra T430 $0.50   12A8425 Optra T430 $0.50   12L0250 Optra W810, W820 $1.00   12S0300 E220 $0.10   12S0400 E220 $0.10   1382620 Optra S $1.00   1382625 Optra S $1.00   1382920 Optra S $1.00   1382925 Optra S $1.00   1382929 Optra S $1.00   13T0101 E312 $0.25   17G0152 M410, M412 $1.00   17G0154 M410, M412 $1.00   23800SW E238 $1.00   23820SW E238 $1.00   24015SA E230, E232, E330, E332 $0.50   64004HA Optra T640 $0.50   64015HA Optra T640 $0.50   64015SA Optra T640 $0.50   64035HA Optra T640 $0.50   64035SA Optra T640 $0.50   E250A11A E350 E352 $0.50   E250A21A E352 $0.50   E352H11A E350 $0.50   E352H21A E352 $0.50 Panasonic   Laser   Qty Code Description Value   UG-3204 UG-3204 $1.00   UG-3309 UF-744/788 $1.00   UG-3313 UF-550/560/770/780 $1.00   UG-3350 UF-585/595 $1.00   UG-5510 UF-780/790/DX800 $1.00   UG-5520 UF-780/790/DX800 $0.10 Samsung   Laser   Qty Code Description Value   ML 1210 D3 ML 1210 D3 $0.50   ML 1610 ML 1610 $1.00   ML 1650 D8 ML 1650 D8 $0.50   ML 1710 D3 ML 1710 D3 $0.25   ML 2010 ML 2010 $0.50   ML 2150 D8 ML 2150 D8 $0.10   ML 2250 D5 ML 2250 D5 $0.10   ML 2660 DA ML 2550 DA $0.10   ML 4500 D3 ML 4500 D3 $0.00   ML 6060 D3 ML 6060 D3 $0.00   SCX 4016 SCX 4016 $0.25   SCX 4216 SCX 4216 $0.25 Total: