WEPIN Store

Retrieval Request Form
(We accept e-gold™)

To request a retrieval of an archived document and to pay online, complete the retrieval information form, select a payment method, complete the appropriate payment information form (credit card, online check, or e-gold™ transfer), and click on the 'Submit Order' button. Note that only checks drawn on a US, Canadian, Puerto Rican, or US Virgin Islands financial institution can be used for the online check payment method but that e-gold can be used from anywhere in the world. Non-US credit cards can be used but the charge amount will be in US Dollars and the actual charge amount that appears on your statement may vary depending on the exchange rates at the time the charge reaches your bank. If you order by ordinary postal mail, you can use a check drawn on any bank as well as a money order or cash. To place an order by ordinary postal mail, fill in the form below, print it out, enclose payment denominated in US Dollars, and send it to:

WEPIN
6112 N. Mesa, Suite218
El Paso, Texas 79912

Retrieval Information Form

Title of Document:
Filing Number (if known):
Your Name:
Email Addresses to Send to:

Select a Payment Method
e-gold™
Credit Card
Online Check

Payment By Credit Card

NOTE: By submitting your credit card information, you are agreeing to pay the charge in accordance with your cardmember agreement just as if you had signed a charge slip.
Please note that your credit card statement will reflect Post Dispatch

Card Type:		Name on Card:
Card Number:		Exp Date:
Amt of Charge:

Payment By Internet Check

(Online check funds must be drawn on a US, Canadian, Puerto Rican, or US Virgin Islands financial institution.)

Write a check payable to WEPIN for the order total including shipping charges, if applicable. Enter the check information into your checkbook register as usual. Use data from the check to fill in the information requested below. Keep the check as your record until the online check appears on your bank statement.

Enter your name and address EXACTLY as printed on the check. Include spaces, commas, periods, etc. If using a joint account, enter both names in order.

Account Name(s):
Address:
City, State, Zip:
Your Phone Number:
Check Number:
Dollar Amount:

Bank Name:
Bank City/St/Zip:

The MICR number across the bottom of the check are bank routing codes plus account and check number. Ignore non-numeric symbols but enter spaces to separate number groups. Please double-check this entry as it is critical to correct processing of the check.
MICR Numbers:

Enter any desired text for the memo section of the check.
Memo:

Payment By e-gold™ Transfer

e-gold™ Payment (Y/N):

(You will be presented with an e-gold transfer form after you have submitted your order by clicking on the "Submit" button below.)