Photoplot Store - Demand Draft Payment Authorization

The PHOTOPLOT STORE's
"E-Check" Demand Draft Payment Authorization Form

To authorize the International Phototool Company to deposit an "E-Check" Demand Draft (similar to sending the check by mail or courier, but much faster and cheaper),
please use this Exclusive form. (Valid only in the USA.)
Simply copy and paste the information below into a new text document (MSWord, Notepad, etc.). Then fill in the information and fax it directly to Richard Sayer at (719) 548-1345.
Please see below for details.

IPC Quote/Invoice Number, or other Job Reference Number:
Name:
Company Name:
Address #1:
Address #2:
City, State, Zip:
Phone Number:
Check Number:
Transit Code: _____-_____ / ________
Date:
Pay to the order of: International Phototool Company
Amount: US$
Amount (text format):
Bank Name:
Bank Address:
Bank Phone Number:
ABA Routing Number (9 digits):
Checking Account Number:

A detailed invoice and payment receipt will be provided upon completion of your order.

Details and Alternate Instructions:

By submitting the above information, I certify that am either a legally authorized representative of and signer for the company named on the account, or I am the actual person named on the account. I hereby authorize the International Phototool Company to bill all specified charges, in immediately available US funds, to the named account upon delivery of the specified order, products and/or services. This authorization shall remain in effect until written notice is received to cancel it.

Once we receive your E-Check payment information, we will print it out and place it in a locked file. A copy will be made and kept in our job folder. Then your e-mail message will be completely purged from our system, so that there can be no unauthorized access to it.

Be sure to void your original check and place it in a secure location or file.

For detailed information about our Internet Commerce Privacy Policy, please click here.

For more information regarding "Checks by Fax", please browse to http://www.checksbyfax.com.