| Your Company Name: | Contact us: | ||
| Your Customer ID: | 361-884-1500 | ||
| E-Mail: Phone: | sales@1099Express.com | ||
| Please make check payable to: | Put CID on check | ||
| Our W-9 | 1099Express.com, Inc. dba NetSoft Marketing EIN: 74-3015861 |
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| 512 WOODLAKE Dr., McQueeney, TX 78123 | NEW ADDR | ||
| Quantity | Description | Unit Price | Total Price |
| _____ | 1099 Express 1 user license | @ $119 = | $ _______ |
| _____ | 1099 Express 2 user license | @ $159 = | $ _______ |
| _____ | 1099 Express 4 user license | @ $198 = | $ _______ |
| _____ | W-2 Express 1 user license | @ $119 = | $ _______ |
| _____ | W-2 Express 2 user license | @ $159 = | $ _______ |
| W-2 Express 4 user license | @ $198 = | $ _______ | |
| _____ | 1042-S Express 2 user license | @ $298 = | $ _______ |
| _____ | 1095-B-C Express 2 user license | @ $399 = | $________ |
| 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 | $ _______ |