(A single duplicate check will be drawn against your checking account made payable to "BIG GUY COMICS".)
Mailing Information:
Name: Street: City: State/Prov: Postal Code: Country:
Part #B -- Branch Number:
Part #C -- Your Name and Address: (exactly as it appears on check):
Part #D -- Bank Name and Address: (exactly as it appears on check):
Part #E -- Bank Transit Number:
Part #F -- Account Number:
Part #G -- Your Phone Number:
Part #H -- Amount To Be Paid: $
I agree to these terms.
***IMPORTANT***