(1) Fill out required form fields below. 
(2) Click 'Submit' Button.(Window will load with Application and Agreement)
(3) Print out re-loaded Application.
(4) Sign and initial in the proper places, then 
(5) Send all necessary documentation to:
Fax: 407-540-9350
or
Mail to:
3D Church Check,
P.O. Box 3063
Ocala, Florida 34478

Notice: All potential users of confidential consumer information must ensure that they do the following: 1.) Be an acceptable and bona fide business entity. 2.) Identify the type of business location and verifiable business address and phone number. 3.) identify the specific and sole purpose for which it intends to use confidential consumer information. 4.) Have knowledge of the FCRA, (Fair Credit Reporting Act). 5.) Provide and maintain security measures for accessing confidential consumer information.

To Review Contract Agreement Please Click Here

Please fill in all necessary text boxes:


General Information

Company Name

Number Of Employees

Address

City State Zip

Type of Business Own or lease

Years in Business Years at this address

Purpose for use

Reports/Checks you anticipate per month?

Special Code (if given one)

Contact Information

Contact Name And Title

Email Address

Phone Fax

Billing Information

Billing Address

City State Zip

County

Email

Accounts Payable Contact

Preferred Monthly Payment Method

Card Type Expiration

Credit Card Account Number

Name of Bank

Checking Account

Routing Number


Name and Address associated with credit card
if different from above


Name

Address

City State Zip

After clicking "Submit", please print the next page,
fill it out completely, and fax it to us immediately
for prompt account setup.

We appreciate your business!