This form is used to acquire the above Ducaller, and the transaction will be deposited and held in a trust account with our financial institution until finalized.
Please make a copy of this page through your browser's "save-as" feature for your records.
Otherwise, if you are transacting a large acquisition or you simply prefer not to use a Credit Card, please use this form.
YOUR E-MAIL ADDRESS MUST BE USED
IN ORDER TO USE THIS FORM
Your e-mail address:
Name:
Address:
Town or City:
State:
Country:
Zip or Postal Code:
Telephone Number:
This is a Secure Check Order Form
Special Instructions
eCheck Payment Details
This form can only be used with
Cheque or Money Order Wire Transfer payments.
It takes on an average 24 hours to process the your information
This time period could vary depending upon the load on the system.
All fields are required.
Bank Information On Cheque (Please fill out completely)
US Funds Only
Personal Cheque
Business Cheque
Letter of Credit
Bearer Bond
Bank Name:
Banks Address 1:
Address 2:
Town/City:
State:
Country:
The actual bank code ( ABA ) number is usually on the top right hand corner:
and read top numbers first (22-33) with / then bottom numbers (555) as shown in photo.
ABA Number:
Cheque Number:
Routing and account numbers across bottom of cheque.
Separate Groups With (-) from left to right.
Example: 123456789-1234-1234567
Routing Number:
Account Number:
Any special instructions on Check wire transfer:
Shipping / Handling costs will be added on
Insert TOTAL Funds Submitted $ USD
By sending this form you are CONSENTING and AGREE that Ducallier Studios use an electronic Bank Draft for this purchase of the "Anticipation" Presentation egg built by us.
Just One more thing !
This is the priority order form, no other method is quicker.