2016 Check Order Form

       
  Your Company Name:   Contact us:
  Your Customer ID:   361-884-1500
  Your E-Mail:   sales@1099Express.com
       
  Please make check payable to: Put CID on check  
Our W-9 1099Express.com, Inc. dba NetSoft Marketing
EIN: 74-3015861
   
  512 Woodlake Dr., McQueeney, TX 78123    
       
Quantity Description Unit Price Total Price
_____ New 1099 Express @ $199 = $ _______
_____ Renewal 1099 Express 1 user license @ $99 = $ _______
_____ Renewal 1099 Express 4 user license @ $198 = $ _______
_____ New W-2 Express @ $149 = $ _______
_____ Renewal W-2 Express 1 user license @ $99 = $ _______
  Renewal W-2 Express 4 user license @ $198 = $ _______
_____ New/Renewal 1042-S @ $298 = $ _______
_____ New/Renewal 1095 Express 1094-1095 @ $299 = $________
       
  Service Bureau Products    
_____ Tin/Name Matching to IRS database @ $74 = $ _______
_____ Service Bureau E-Filing 1st file @ $75 = $ _______
_____ Service Bureau E-Filing additional files @ $75 = $ _______
_____ CD-ROM @ $15 = $ _______
        Texas Residents add 6.75% sales tax   $ _______
    Total $ _______