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Text File  |  1995-02-16  |  1KB  |  13 lines
  1. @X13┌─────────────────────────────────────────────────────────────────────────────┐
  2. │@X1E1) Name:                             7) Phone:                               @X13│
  3. │@X1E2)                                                            Date           @X13│
  4. │@X1E3) Addr:                                                                     @X13│
  5. │@X1E4) City:                             5) State:             6) Zip:           @X13│
  6. │                                                                             @X13│
  7. │  @X1FPay to                                                        ┌─────────┐  @X13│
  8. │  @X1Fthe order of:  Online Electronic Banking                     $│         │  @X13│
  9. │  @X1F                                                              └─────────┘  @X13│
  10. │                                                                             @X13│
  11. │  |:         |:                     ║▀                                       @X13│
  12. └─────────────────────────────────────────────────────────────────────────────┘
  13.