
                                 I N V O I C E


                                  Fax & File
                                P.O. Box 270539
                           Houston, Texas 77277-0539
 
   Date: 


  ___________________________________________________________________________
  From:

  Name_____________________________________________________

  Address_________________________________________________

  City______________________________ State_____Zip_________

  Social Security #________________________________

  Daytime Phone_____________________Evening Phone_______________________

  Fax Phone # Used to Send the Fax_________________________________

  ___________________________________________________________________________
                                        Your pre-tax amount is: $15.95
                              Texas Residents add 7.5%     Tax: $
                                                         Total: $
  ___________________________________________________________________________

Credit Card Payment Signature Block
Card Type:  Visa / MC  (Circle one)
Expiration Date:________________

Card #___________________________________________

Sign Your Name as it appears on your credit card

________________________________________________________Date Signed___________


           Please submit your payment (if not paying by credit card)
                                and all output to:

                                  Fax & File
                                P.O. Box 270539
                           Houston, Texas 77277-0539
                         Attn: 1040EZ Filing Division

