Pay By Check

 

BILLING INFORMATION


Insta-Chex

Now Only $499.95 each  

        Quantity   

Total   

To pay by check, please complete this check and submit.
We will then create a bank draft and deposit accordingly.
Once the funds have cleared, we will ship your order to the address indicated on your check.

Items in RED are required.

Your name as it appears on your check

 Your address as it appears on your check

 Your city, state & zip code
,


Check number  

                 Your phone number
                            

                            Amount     

Pay To The Order Of          FAPS                                                  

Dollar Amount                             US Dollars     

Bank Name

                   

Bank Address 

  

 

Bank City, State, Zip   

Signature - Type your full name here   

                 

Bank Routing Code and Account Number     

      Enter the numbers from the bottom of your check as illustrated below.


For security purposes, enter the last four digits of your social security number.

Enter your email address.