By submitting this form you authorize yourfavorite.com, a division of M&R Industries, Boston, MA, to draft a check on your bank account for the amount shown below if paying by check. You will receive a copy of the check in your next monthly bank statement. MA residents must include 5%. If paying by credit card you agree to abide by your cardholder agreement and by pushing submit you agree to the charges you submit.

Please provide the following information for shipping.
(Must be the same as address on check or credit card statement):
(Must be the same as address on check or credit card statement):
Name on Check or Card
Company Name (If Any)
Address
City State Zip .
Phone Number
E-mail Address

^{Pay by MasterCard / VISA}
Card Number Exp. Date

Pay By Check
Bank Name
Bank City Bank State
Fraction Code .(Example 5 - 215/1011) Located At Top Right of Check
Check Number
Account Number
Routing Number
Enter Total sequence at bottom of check / left to right:
Use /: for transit symbol / for ON US symbol and /// for the symbol

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