CANADA

CheckWriter Order Form

To order CheckWriter products, complete the form and fax or mail it to the address listed at the bottom of the page. Should you have questions, do not hesitate to contact us at 617-859-8998.

Product / US Price / Additional S & H / Shipped By: / Total / Quantity
CheckWriter Best Deal Package
Single User / $129.99 / $10.00 / US Express mail
5 – 7 business days / $139.99
CheckWriter Network Edition
Multi User / $379.00 / $10.00 / US Express mail
5 – 7 business days / $389.00
100 Sheets Check Stock
Top Check 1-up Grey / $19.99 / $10.00 / US Express mail
5 – 7 business days / 29.99
500 Sheets Check Stock
Top Check 1-up Grey / $59.99 / $35.00 / US Express mail
5 – 7 business days / $94.99
2500 Sheets Check Stock
Top Check 1-up Grey / $199.99 / $55.00 / UPS Ground
7 – 10 business days / $254.99
5000 Sheets Check Stock
Top Check 1-up Grey / $393.99 / $99.00 / UPS Ground
7 – 10 business days / $492.99
1500 Checks – 3 per page
500 sheets 3-up Burgundy / $144.99 / $35.00 / US Express mail
5 – 7 business days / $179.99

Add Customs Declaration charge per order - $19.99 USD

TOTAL: USD $______

* All Charges are in US Dollars * All shipping and handling charges include international shipping/handling cost difference plus $19.99 customs declaration charge applied to orders shipped to Canada. * Recipient is responsible for all import taxes * Delivery times are estimates only *

Please ship my order to: My Credit Card Billing Address:

Name: ______

Company: ______
Address: ______
City, St, Zip: ______

Phone Number:______
eMail Address for order confirmation: ______

Credit Card: ______Exp: ______

Signature: X______Date: ______

q  Please charge my credit card for payment

Total $______USD including shipping for ______.

[product description]

Mail orders to: CheckWriter Orders, P. O. Box 641 Boston MA 02123

PLEASE NOTE: Orders submitted BOTH by mail AND by fax may be processed in duplicate.

Form Revision 8.5