Name: Email: Phone Number: Address: City: State / Province: Select a State or Province Armed Forces Americas , USA Armed Forces Europe , USA Alaska , USA Alabama , USA Armed Forces Pacific , USA Arkansas , USA American Samoa , USA Arizona , USA California , USA Colorado , USA Connecticut , USA District Of Columbia , USA Delaware , USA Florida , USA Fed States of Micronesia , USA Georgia , USA Guam , USA Hawaii , USA Iowa , USA Idaho , USA Illinois , USA Indiana , USA Kansas , USA Kentucky , USA Louisiana , USA Massachusetts , USA Maryland , USA Maine , USA Marshall Islands , USA Michigan , USA Minnesota , USA Missouri , USA Mississippi , USA Montana , USA North Carolina , USA North Dakota , USA Northern Mariana Islands , USA Nebraska , USA New Hampshire , USA New Jersey , USA New Mexico , USA Nevada , USA New York , USA Ohio , USA Oklahoma , USA Oregon , USA Pennsylvania , USA Puerto Rico , USA Palau , USA Rhode Island , USA South Carolina , USA South Dakota , USA Tennessee , USA Texas , USA Utah , USA Virginia , USA Virgin Islands , USA Vermont , USA Washington , USA Wisconsin , USA West Virginia , USA Wyoming , USA Alberta , CAN British Columbia , CAN Manitoba , CAN New Brunswick , CAN Newfoundland , CAN Nova Scotia , CAN Northwest Territories , CAN Ontario , CAN Prince Edward Islands , CAN Saskatchewan , CAN Yukon Territory , CAN Quebec , CAN Not USA or Canada Zip / Postal Code: Country: United States Canada Argentina Aruba Australia Bahamas Barbados Barbuda Belgium Bermuda Bolivia Brazil Brunei Cayman Islands Cyprus Denmark Dominica Equatorial Guinea Falkland Islands Finland France French Polynesia Germany Gibraltar Greenland Grenada Guinea Guyana Honduras Hong Kong Iceland India Israel Italy Japan Luxembourg Madagascar Mexico Netherlands Netherlands Antilles Norway Oman Panama Paraguay Portugal Qatar Santa Cruz Islands Saudi Arabia Singapore South Africa South Korea Spain St Christopher & Nevis St Helena St Lucia St Thomas & Principe St Vincent & Grenadines Sweden Switzerland Taiwan Trinidad & Tobago United Arab Emirates Uruguay   Comments:   Panama Pump Company Post Office Box 15626 Hattiesburg, MS 39404 Phone: 601.544.4251 Fax: 601.544.4252 Toll Free: 1.800.734.7426