WORKSHEET for processing order by: @TYPEORD@ ------------------------------------------------------------------------------ Name on BBS: @BBSFNAME@ BBS Name: @BOARD@ Date: @DATE@ Time: @TIME@ ------------------------------------------------------------------------------ Type Card: @CARDTYPE@ Card Expires: @CCEXPIRE@ Card Number: @CARDNUMBER@ Authorization Number: ____________ Name on Credit Card: @CCNAME@ Street Address: @STREET@ City: @CITY@ ZipCode: @ZIP@ Home Phone: @HPHONE@ Work Phone: @WPHONE@ Card Processor: @PROCESSOR@ State to charge tax: @TAXSTATE@ Tax Exemption Number: @TAXEXEMPTNO@ ------------------------------------------------------------------------------ Items Ordered: PRICE Qty DESCRIPTION @ITEMS@ Subtotal: @SUB_TOTAL@ Your Tax: @TAX@ Shipping Costs: @SHIPPING@ Handling %: @HANDLING@ __________ Total - @TOTAL@ ------------------------------------------------------------------------------ Type Account: @CKTYPECKACT@ - CHECK INFORMATION - NO. @CKCHECKNO@ Drivers Lic/SSN @CKDLNUM@ @CKSSN@ @CKCOMPANY@ @CKF_NAME1@ @CKL_NAME1@ @CKF_NAME2@ @CKL_NAME2@ @STREET@ @CITY@, @STATE@, @ZIP@ @HPHONE@ @TOTAL@ @CKMEMO@ Authorized by: @CKAUTHNAME@ ------------------------------------------------------------------------------ PAGE 1 PAGE 2 ------------------------------------------------------------------------------ BANK INFORMATION for @CKCOMPANY@ @CKAUTHNAME@ Name of Bank: @BANKNAME@ Street Address: @BANKSTREET@ City: @BANKCITY@, @BANKSTATE@ @BANKZIP@ Phone(if known): @BANKPHONE@ routing: @CKROUTENO@ Acct: @CKACT@ ABA Transit code: @UPPERABA@/@LOWERABA@ ------------------------------------------------------------------------------ Check guarantee service used for this transaction:(circle one) YES NO Authorization number:________ Notes:_________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Check deposited on_________________ Hold order:____ days. OK to ship______ Ship on:___________ VIA: @SHIPTYPE@ Attach/staple Check Duplicate below: ----------------------------------------------------------------------- -----------------------------------------------------------------------