PAY
to
the order of
100 DOLLARS
FOR
PER
DATE
TO
FOR
BALANCE
FORWARD
FORWARD
THIS
CHEQUE
CHEQUE
DEPOSIT
DEPOSIT
OTHER
BALANCE
PST AMOUNT
GST / HST AMOUNT
GST / HST NO.
Safeguard Business Resources 1-800-203-9828 Order # TEMP-17475
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