Type of Mailer: LA 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 Please enter the words you see in the box, in order and separated by a space. Doing so helps prevent automated programs from abusing this service. If you are not sure what the words are, either enter your best guess or click the reload button next to the distorted words. 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!