To request a photocopy of a Fidelity Express money order, complete and sign this form, enclose it with
the necessary payment, then mail, email or fax via the contact information below.
Incomplete or ineligible forms could delay your request. Please allow up to 30 days for processing.
Money Order Information
City State Zip
Reason for copy
For copies of money orders less than one (1) year old, the processing fee is $10.00 for each request.
For copies more than one (1) year old, the processing fee is $20.00 for each request.
Processing fees are non-refundable and subject to change without prior notice. Each request requires a separate form.
Once you have completed the information above, print this form using the browser’s print option.
Sign the completed form and submit with payment via mail, email or fax information below.
Submit Signed Form and Payment to:
PO Box 768
Sulphur Springs, Texas 75483
To pay via credit card, complete the following information (name must match signature below):
I, , give Fidelity Express permission to charge my credit card the proper fees for
copy/ copies of the money order indicated above. I understand the non-refundable fee is $10.00 per copy for money
orders less than one (1) year old and $20.00 per copy for money orders more than a year old. These non-refundable
processing fees are subject to change without prior notice.
Card Number Card Expiration
Select One: Visa MasterCard Discover American Express
Name on Card Amount Due $
Card Billing Address
City State Zip
Sign Here in Ink Date
Money Order Photocopy Request Form