Fax Your Payment Check Using This Form To (916) 372-3007

***** CHECK-BY-FAX PAYMENT ORDER FORM *****
You must complete the entire form or your order cannot be processed. You will need to tape or paste your completed check in the blank space below. Fill out and sign the authorization section below, and fax the ENTIRE FORM WITH YOUR CHECK to (916) 372-3007. Your order will be completed after we receive clearence of your payment from your bank. Your bank check clearence can take up to 9 working days. (When you feel your bank will not clear your check immediately, we recommend for faster service, using either overnight mail of a postal or international money order or using your credit card.)

PRODUCT/SERVICE You are ordering: ___________________________.

First Name:_________________________________________________________

Last Name:_________________________________________________________

Company:______________________________________________________

Street Address:______________________________________________________

City:______________________________________________________

State: _____________________ Zip:_________________________

Phone Number:________________________________________________________

EMail Address:_______________________________________________________

* * * * * * * * * * Authorization * * * * * * * * * *
* * * * * * * * * Terms & Conditions * * * * * * * * * *

I, ______________________________________ hereby authorize Major Communications to withdraw $_____________________________ from my checking account, account information enclosed, one time only, for the purchase of _________________________________. I have read and I understand the Terms & Conditions as stated above. The signature below is the authorized signature of the holder of the checking account.
Authorized Signature:_________________________________________________

Date:__________________

Attach Your Check Here From The Checking Account You Will Pay For This Product or Service!
Please make sure that your check will fax clearly. Large and dark pictures on checks will make your fax unreadable.

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