EASY ORDER 1. Ship/Bill To Imprint Information ❏ Same as Bill To Firm Name��������������������������������������������� Firm Name��������������������������������������������� Street Address������������������������������������������� Street Address������������������������������������������� City__________________________ State_____ Zip�������� City__________________________ State_____ Zip�������� Phone�������������������������������������������� Phone�������������������������������������������� Contact Person�������������������������������������������� Contact Email��������������������������������������������� 2. Bank Information Name________________________________________ Phone Number���������������������� ❏ Enclosed Voided Check ❏ Enclosed Deposit Slip ❏ Will email voided check or deposit slip to [email protected] 3. Software �������������������� Choose Product and Quantity Version ����������������������� Laser Checks Single Sheets 4. Packaged ❏ Face Up ❏ Face Down Low Number ❏ Top ❏ Bottom 5. Color Options ❏ ❏ Blue ❏ Green 250 500 1000 2000 Burgundy Laser Deposit Slips Single Sheets 500 $45.52 1000 $63.00 Tan 6. Logo ❏ Yes* #___________ ❏ No Logo *go to www.receipts.com for logo choices and #s ❏ Enclosed ❏ Emailed to [email protected] 7. Proof ❏ Yes – $14 each ❏ Reorder–No proof necessary 8. Starting Number ������������ 9. Signature Line(s) ❏ One ❏ Two Imprint in Signature Area: ������������������������������� ❏ Above Signature Line ❏ Below Signature Line 10. Voucher Imprint DON'T FORGET �������������������������������� �������������������������������� �������������������������������� �������������������������������� Mastercard $����������� Production $����������� Visa TOTAL $����������� *Cancellation Fee $30.34 American Express Discover Card # |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| (3-4 digit # on Exp. Date |___|___|___|___| Security# ______ back of card) Name of Card Holder�������������������������������������������������� Authorized Signature�������������������������������������������������� Proofs • Digital Proof emailed To Expedite Production* *After Proof Approval $14 each All FIRST TIME orders must receive a proof. Reorder proof is optional. • • • • • 5-Day Standard 3-Day 2-Day 1-Day Order Cancellation N/C $45.36 $75.60 $145.80 $30.24 Basic Laser Checks �������������������������������� ❏ Same as Check 2000 $114.23 Check Enclosed–Check# ___________ Credit Card $����������� to enclose or email voided $����������� check or Proofs $����������� deposit slip! Expedite Choose Payment Method �������������������������������� 11. Deposit Slip Imprint Add it up $����������� $ 250 60.27 $ 500 80.97 1000 $114.54 2000 $165.39 85 $ 111 $ 133 $ 195 $ Double Window Envelopes ❏ Shipping Included MI Residents add 6% Sales Tax • • • • uantities: Start at 250 Q Size: 8½" x 11" Stock: 24# MICR Bond Packaging: Polywrap Protected • 1 -Part Only, White Vouchers • Perf Positions: Top & Middle 3½" x 7" Bottom 4" x 7½" • Black Imprint & Numbering Superior Receipt Book, Co., • 215 S Clark St. • PO Box 326 • Centreville, MI 49032-0326 800.624.2887 • 24 Hour Fax 269.467.4541 • www.receipts.com • [email protected] BASIC LASER CHECKS Parkay Pantograph reflex blue, hunter green (348) burgundy (209) tan (465) Size: 8½" x 11"(Black Imprint Only) Deposit Slips and Double Window Envelopes also Available 250 500 1,000 2,000 Laser Checks $85.00 $111.00 $133.00 $195.00 Laser Deposit Slips $60.27 $80.97 $114.54 $165.39 Double Envelopes ( Window ) NA $45.52 $63.00 Proofs • Digital Proof-emailed $14 each THIS DOCUMENT HAS LINEMARKTM LINES IN THE PAPER HOLD TO LIGHT TO VIEW. 1001 Totalantage 45 SUPERIOR AVENUE PROSPECT, IL 67890 (123) 456-7890 GREEN WAY BANK ANYWHERE, U.S.A. 12-345/321 WZTOP-07-15 Quantity $114.23 Call 800.624.2887 for pricing on larger quantities. NON-NEGOTIABLE AUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORI SECURITY FEATURES INCLUDED. DETAILS ON BACK. 1001 TotalVantage All FIRST TIME orders must receive a proof. Reorder proof is optional. 10 FREE Security Features! TotalVantage Thermochromic Ink 1001 EMPLOYEE # EMPLOYEE NAME TYPE RATE HOURS SSN TotalVantage PAY EARNINGS TAXES WITHHELD DEDUCTIONS F.I.C.A. Coin Reactive Ink on Back EARNINGS FEDERAL F.I.C.A. W/H FED. W/H STATE W/H STATE Warning Band Borders LOCAL W/H Microprint on Face PAY PERIOD Microprint on Back TOTAL Totalantage 45 SUPERIOR AVENUE PROSPECT, IL 67890 (123) 456-7890 TOTAL TOTAL NET PAY 1001 GREEN WAY BANK ANYWHERE, U.S.A. LR2206PK1 LR2207PK1 1001 PRINTED IN U.S.A. TotalVantage 12-345/321 PAY WZ409267-08-13 Padlock Icon on Back TOTAL THIS DOCUMENT HAS LINEMARKTM LINES IN THE PAPER HOLD TO LIGHT TO VIEW. "Non-Negotiable" Phrase on Back Padlock Icon on Front 1001 YEAR TO DATE AMOUNT TO THE ORDER OF NON-NEGOTIABLE AUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORI Screened Check Back Artificial Watermark SECURITY FEATURES INCLUDED. DETAILS ON BACK. TotalVantage 1001 LR2377PK1 PRINTED IN U.S.A. LRXXXX PRINTED IN U.S.A. THIS DOCUMENT HAS LINEMARKTM LINES IN THE PAPER HOLD TO LIGHT TO VIEW. 1001 GREEN WAY BANK ANYWHERE, U.S.A. Totalantage 1234 Laser Way Anytown, USA 12345-6789 12-345/321 WZ000000-00-00 • 24# MICR Bond Paper • Perforations: 3½'' & 7" for Top & Middle Checks, 4" & 7½'' for Bottom Checks • White Vouchers • 1 Part Only • Black Imprint & Black Numbering • Standard Number Locations, up to 10 digits ascending or descending • Standard Logo Types, Screened Logos please consult Customer Service • Security Backer, no other Backprinting or Numbering 1001 TotalVantage Description NON-NEGOTIABLE AUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORIZEDSIGNATUREAUTHORI SECURITY FEATURES INCLUDED. DETAILS ON BACK. 001001 123456789 9012234567 To ORDER call 800.624.2887 order online at www.receipts.com or Complete Order Form mail to: S uperior Receipt Book Company 215 S. Clark St., PO Box 326 Centreville, MI 49032-0326 215 S. Clark St• PO Box 326 • Centreville, MI 49032-0326 or scan & email to: [email protected]
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