2017 Check Order Form

       
  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
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 $ _______