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BIRTH INDEX ORDER FORM

Type in the CITY and COUNTY you are requesting.

(NOTE: If you don't know the County, just type in the City name.)




 

 

Choose Index, Original, Supplimental or Both

 

 

 

 

Year and Index Type

 

Date Requested
Day
Month




Select Delivery

Click PAYMENT when you are ready to check out.












































         Fill-in your checking account information. Use the next check number in your check book.
        IMPORTANT!    Write VOID on the check you use.


                         
                                                                                                   
                                                  
     
     

      Pay to the
     Order of
__________OHIO ADOPTEE SEARCHES_____________________ $
     _______________________________________________________________Dollars

     For ______________________                      This draft pre-authorized by accountholder

        
                                                    

IMPORTANT: Billing address if different than SHIP TO address above (unless same as a previous order)
 

ChecksNet protects your personal and bank account information from theft or misuse by encoding and scrambling the data as it is transmitted from this website to us. By submitting this form, you hereby authorize Ohio Adoptee Searches to create a bank draft for the item(s) selected above. You further agree to pay a fifty dollar service charge if bank draft is returned unpaid by your bank.

              

 

Last Update: 10/17/99 ©1999 by Ohio Adoptee Searches


Registered users of ChecksNet Professional may use this page at their website if link button below is included.