Type of Mailer: CA LTC Letter Demographic Selections If you ran your own count, enter query number: OR fill out demographics below: Age: Date of Birth: Income Range: Omit PO Boxes: -Select- Yes No Phone Numbers: -Select- Yes No Other: ZipCodes, SCF and/or County: Separate all zip codes, SCFs and/or counties using a comma. List in order of preference. Notes/Special Instructions Order Quantity & Totals Number to Mail: @ Total = /M If quantity is 500-999, add $50 flat set up fee. If under 500, add $100 set up. Does not include shipping/handling or tax for TX orders. Billing and/or Shipping Address Company: Name: Address: City: State: Zip Code: Phone #: Fax #: Email: Payment Method: -Select Payment- Check Credit Card Note: We will contact you for card information. Order is subject to zip code availability under our 90 day file protection policy Send Order Confirmation By: -Select- Email Fax I have seen a Mail Piece Sample: -Select- Yes No Submit Want our recommendations or to have us run your count? Give us a call (800) 723-5254 or send an email to email@example.com and we are happy to help!