4 Precious Metals Virtual Check Fax Form

4 Precious Metals - Fax Virtual Check Form

First, fill out this form with all required information and then use your browser's print button to print it.
Then FAX the printed form to 303-428-1842. You may then use your "back" button to return to our site.

Please indicate the number of copies desired

The Gold Book - $19.95 + $1.95 S & H
The Platinum & Palladium Book - $24.95 + $4.50 S & H
A Chequered Life Audio Tape - $9.95 + $1.95 S & H

Colorado Orders must add Sales Tax:

Name of Authorizing Person

Your Name / Complete Address and Additional Information as it
appears on Check. 1

Daytime Phone/FAX number

P: F:

E-Mail address for Replies
Please double-check!

2Check Number - Use actual check number then void the check.
3 Transit Code (ex:63-751/1002) (looks like a fraction)

Bank Name/Branch 4
Address
City, State, Zip
Bank Phone (if on check)

These numbers appear on the bottom
of your check - they may also contain
the check number that should be ignored.

9 Digit Routing Number 5

Checking Account Number 6

________________________________ After Printing, please sign on the line to the left.
My signature authorizes Millennium Publications to use the above information to generate a VirtualCheck for the Order Total. This authorization is for this transaction only. I understand Westminster Publishing Company will send a duplicate voucher receipt of the VirtualCheck draft upon my request. We CAN NOT process your order without your signature here.

Please tell us how you heard about our books.