TO PRINT:  RIGHT CLICK AND SELECT PRINT                                            

 Q~Check   purchased as a single site license that allows a company  to install the software on up to 10 computers at the single site.  This license will be in effect  for 1 year - at that time you must renew for additional period (normally 1 year). Please note that prices are subject to change.  Questions: call 732 229 6060.  

Item

Quan.

Shipping Included

Price Ea.

Total

Q~Check Platinum with  4 "Pay To" &  25,000 Banks Database -
1 Year License  
1 Download 99.00  
Renew your Q~Check License If Time is Expiring -
1 Year License Renewal 
1 Download 59.00  
Check Paper (3 checks per sheet)

100 Sheets

UPS Ground 

16.95  

"

200 Sheets " 26.95  

"

500 Sheets " 49.95  

"

2500 Sheets " 139.95  

Deposit Slips - 1 Per Page

100 Sheets " 16.95  
      Total Cost:   
Co. ID:                                    Company Name: Contact:
Address:                                                                                                   
City: St: Zip:
Phone:                                                                             Email:
Pay to Line 1:                                                                                              Pay to Line 3:
Pay to Line 2:                                                                                              Pay to Line 4:
If a company referred you to Q~Check:   Referring Company:                                                           Referring Contact Person:

I authorize EBSEFT LLC (dba Q~Check)  to initiate a one time electronic deduction from my bank account (account information on attached check) for the total purchase amount shown.  Returned electronic check items shall incur a $ 20.00 charge which shall be electronically represented.

Name:  ______________________________        Signature:______________________________________        Date:______________

  PLEASE FAX BLANK VOIDED CHECK WITH THIS ORDER -

FAX TO: 815 550 8620

EMAIL: qchecksupport@gmail.com