EZBIZZ Checks

Please Fill This Form Accurately and Carefully as
This form will be processed without our having to re-type it.

Please add a note in the comment field (at bottom of form) below if you would like information about our e-check and fax check processing software or if you have any questions.

Your first name

Your last name

Address

City For any Questions or Problems - Call

State or Province Larry McIntyre at 770 578-6886

Zip or Postal Code

Phone

Best time to call

Fax (optional)

Your E-Mail address

Write in what you are purchasing, ie: (Ezbizz website,- 50,000 Unique Visitors, Net-Checks, ect.)

Account Holder's Name on the Check

Check Number (record this check in your check book)

Name of Bank

City and State or Province where Bank is located

Fractional ABA number (for USA banks only) looks like 91-210/1225

9 digit Bank Routing or Transit Number (Canadians MUST put a hyphen in the 6th position - all funds are US Dollars)

Your Account Number (include spaces and hyphens)

Amount of Check

CHECK THIS BOX AFTER READING BELOW
By Checking this box declares that I am making this transmittal check payable to Everett L. McIntyre for the purchase as described above and I have filled in all of the check information fields above and certify that all information is complete and correct. - By checking the above box I authorize you to use a check writing software to print a check on my bank for the above selected items in the amounts shown. I understand that the check will show up just like any other check on my monthly bank statement. I also authorize you to draft my account electronically for the face amount of this check AND appropriate returned check fees if my check is returned unpaid for any reason - YOUR ORDER WILL NOT BE PROCESSED IF THIS LITTLE BOX IS NOT CHECKED!

Note: All Check Information Submitted Above Is Automatically Read by a Software Program and Submitted Into The Check Writing Program, Please Double Check Your Information. Thank You.

Please Tell Us Your URL: (Website Address)
Use To Tell or ask me a question.

Please Put Your URL (Website Address) Here.

Please make sure the form is complete and accurate.

Be sure to read the Tips on how to use your EZBIZZ Website.
(For IGP Customers Only)
CLICK HERE

GO TO EZBIZZ RETAILER'S NOOK & NEWS
(For IGP Customers Only)
CLICK HERE

Go To Unique Visitors Order Page
(IGP Customere)
Click Here

Payment by Net-Check for any products or services purchased from Everett "Larry" McIntyre /dba Financial Connections.