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The Correct Forms for the
Perfect Software!
Industry Specific Forms Tailored For COATS
Your COATS Authorized Forms Provider
P R I N T I N G
Clerical and Industrial Applications
W-4
Form
Department of the Treasury
Internal Revenue Service
1
Employee's Withholding Allowance Certificate
OMB No. 1545-0074
a Whether you are entitled to claim a certain number of allowances or exemption from withholding is
2014
subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS.
Your first name and middle initial
Last name
2
Home address (number and street or rural route)
3
Single
Married
Both COATS SQL and COATS Standard available
Spanish versions also available
Your social security number
Married, but withhold at higher Single rate.
Note. If married, but legally separated, or spouse is a nonresident alien, check the “Single” box.
City or town, state, and ZIP code
4 If your last name differs from that shown on your social security card,
check here. You must call 1-800-772-1213 for a replacement card. a
5
6
7
5
Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2)
Additional amount, if any, you want withheld from each paycheck . . . . . . . . . . . . . .
6 $
I claim exemption from withholding for 2014, and I certify that I meet both of the following conditions for exemption.
• Last year I had a right to a refund of all federal income tax withheld because I had no tax liability, and
• This year I expect a refund of all federal income tax withheld because I expect to have no tax liability.
If you meet both conditions, write “Exempt” here . . . . . . . . . . . . . . . a 7
Under penalties of perjury, I declare that I have examined this certificate and, to the best of my knowledge and belief, it is true, correct, and complete.
Employee’s signature
Your Name & Logo Here
(This form is not valid unless you sign it.)
8
Date a
For Privacy Act and Paperwork Reduction Act Notice, see page 2.
NAME: (LAST, FIRST, MIDDLE)
STREET
ADDRESS:
9 Office code (optional)
STATE
❑ YES
Form W-4 (2014)
ALIEN REG. EXP. DATE
ALT. TELEPHONE
SMOKING ENVIRONMENT
❑ YES
Your Name & Logo Here
MINIMUM RATE PER HOUR
HAVE YOU EVER BEEN CONVICTED
OF A FELONY? ❑ YES ❑ NO
$ ______________/HR.
NAME: (LAST, FIRST, MIDDLE)
CITIES AVAILABLE TO WORK IN
CITY & STATE OF BIRTH
WPM
LTR
ALPHA
NUM
10 KEY
SOFTWARE PACKAGES:
TYPING - APPROX.
DATA ENTRY:
SPEED _____ W.P.M.
ALPHA
❑
NUMERIC ❑
❑ Memory
RECEPTIONIST:
❑ Manual
# Of Incoming Lines
❑ Electric
# Of Extensions
❑ Selectric
❑ Stencils and
Masters
❑ Statistical Typing
CLERICAL # WRONG
1ST
3RD
2ND
4TH
SPELLING
SOFTWARE PACKAGES:
❑ Invoicing & Billing
❑ Steno
❑ Transcriber
TO
EDUCATION
NAME OF SCHOOL
DEGREE
ZIP
❑ YES
TOTAL NO. OF INCOME
TAX EXEMPTIONS
HOME TELEPHONE
ALIEN REG. EXP. DATE
ALT. TELEPHONE
SMOKING ENVIRONMENT
❑ NO
❑ YES
EMAIL ADDRESS
❑ NO
COMPUTERS:
CLERICAL:
BUSINESSINMACHINES:
CASE OF EMERGENCY, NOTIFY - NAME:
ADDRESS Types Of Computers: ❑ MAIN ❑ MINI
TELEPHONE
❑ Filing
❑ MAC ❑ PC
❑ Numeric
❑ Coding
❑ Alpha
❑
Adding Machines
HOW DID YOU HEAR OF US?
DATE AVAILABLE TOSTENOGRAPHIC:
WORK
MINIMUM RATE PER HOUR
WHAT POSITION ARE YOU APPLYING FOR?
HAVE YOU EVER BEEN CONVICTED
❑ Posting ❑ Other
Approx. Speed _______W.P.M.
❑ Full
❑ 10 Key
❑ Touch
OF A FELONY? ❑ YES ❑ NO
$ ______________/HR.
❑ Bulk Mail
❑ Legal Steno
❑ Fax
FULL TIME
WHICH DAYS ARE YOU AVAILABLE TO
CITIES
TO WORK IN
❑ AVAILABLE
Medical Steno
Telemarketing
❑ WORK
❑ AVAILABLE LONG TERM ASSIGNMENT
❑ Postage Meter
AVAILABLE
TO
WORK
FROM:
❑ 1ST SHIFT
❑ Transcribing Machines
❑ WILL ACCEPT SAME DAY ASSIGNMENT
❑ Customer Service
❑ Calculators
❑ 2ND SHIFT
______A.M. TO _______A.M. ❑ TEMP TO HIRE
❑ THU ❑ FRI ❑ SAT ❑ SUN
❑ CAR AVAILABLE? ❑ YES ❑ NO
❑ 3RD SHIFT
BOOKKEEPING:
Kinds ❑ MON ❑ TUE ❑ WED
______P.M. TO _______P.M. ❑ RESUME ATTACHED? ❑ YES ❑ NO
❑ Full Charge ❑ Assistant
❑ Speak
FOREIGN LANGUAGES:
OTHER:
❑ Accts.
Pay. of❑work
Manual
WORK SKILLS - Check your skills
and kind
you have done.
❑ Read
SUPPLIES AVAILABLE
Driver’s License?
❑ Accts. Rec. ❑ Computer
❑ Write
WAREHOUSE
FACTORY
GENERAL
EQUIPMENT
MAINTENANCE
❑ Hard Hat
❑ Yes
❑ No
/ Machines
❑ Bookkeeping
OTHER SPECIAL SKILLS & EXPERIENCES:
❑ Computer Skills
❑ Mechanical
❑ Carpenter
❑ Construction
❑ Building Repair ❑ Truck
❑ Collections
❑ Payroll
❑ Tools
License Number
❑ Reconciliations
❑ Taxes
❑ Receiving
Assembler
❑ Electrician
❑ Painter
❑ Backhoe
❑ Cleaning
❑ Glasses
ElectronicPOSITION ❑ Floor Care
❑ Inventory PAY❑P/HOUR
Tractor
REASON ❑
FOR
LEAVING
PHONE OR ADDRESS ❑ Plumber SUPERVISOR
Assembler
❑ HVAC
❑ Mover
❑ Outside Fl.
❑ Landscaping
❑ Inspector
❑ Welder
❑ Laundry
❑ Crane
❑ Lawn Care
❑ Solderer
❑ Road Const. ❑ Packager
❑ Drill
❑ Hotel Cleaning
❑ Demolition
❑ Digger/Raker ❑ Quality Control
❑ Saw
❑ Janitorial
❑ Casual Labor ❑ Machine Operator
❑ Supervisor
❑ Nail Gun
PREVIOUS EMPLOYMENT NAME OF EMPLOYER
FROM
SOCIAL SECURITY NUMBER
RIGHT TO WORK IN U.S. ALIEN REG. #
WORK SKILLS - CHECKS YOUR SKILLS AND KIND OF WORK YOU HAVE DONE.
%
STATE & FEDERAL LAW PROHIBITS
DISCRIMINATION BASED ON AGE.
SEX OR NATIONAL ORIGIN
AN EQUAL OPPORTUNITY EMPLOYER
HOW DID YOU HEAR OF US?
❑ AVAILABLE LONG TERM ASSIGNMENT
AVAILABLE TO WORK FROM:
❑ 1ST SHIFT
❑ WILL ACCEPT SAME DAY ASSIGNMENT
TO HIRE
❑ 2ND SHIFT
______A.M. TO _______A.M. ❑ TEMP
STREET
CITY
STATE
❑ CAR AVAILABLE? ❑ YES ❑ NO
❑ 3RD SHIFT
______P.M. TO _______P.M. ❑ RESUME ATTACHED? ❑ YES ❑ NO
ADDRESS:
❑ MON ❑ TUE ❑ WED ❑ THU ❑ FRI ❑ SAT ❑ SUN
TEST RESULTS
speed
errors
EMAIL ADDRESS
❑ NO
TELEPHONE
DATE AVAILABLE TO WORK
WHICH DAYS ARE YOU AVAILABLE TO WORK FULL TIME
TOTAL NO. OF INCOME
TAX EXEMPTIONS
HOME TELEPHONE
❑ NO
ADDRESS
WHAT POSITION ARE YOU APPLYING FOR?
Employer identification number (EIN)
ZIP
RIGHT TO WORK IN U.S. ALIEN REG. #
IN CASE OF EMERGENCY, NOTIFY - NAME:
10
Cat. No.
10220Q
SOCIAL
SECURITY
NUMBER
CITY
CITY & STATE OF BIRTH
STATE & FEDERAL LAW PROHIBITS
DISCRIMINATION BASED ON AGE.
SEX OR NATIONAL ORIGIN
AN EQUAL OPPORTUNITY EMPLOYER
a
Employer’s name and address (Employer: Complete lines 8 and 10 only if sending to the IRS.)
❑ Mechanic
❑ Jack Hammer
GRADUATED? HAVE YOU
EVER WORKED FOR OR APPLIED WITH A TEMPORARY SERVICE? ❑ YES ❑ NO
❑ Validator
IF YES, PLEASE LIST THE FIRMS AT WHICH YOU WORKED AS A TEMPORARY.
Firm Names & Addresses:
PREVIOUS EMPLOYMENT NAME OF EMPLOYER
PHONE OR ADDRESS
FROM
❑ Shipping
❑ Load / Unload
❑ Hand Jack
❑ Steel Toe Work Boots
❑ Forklift
❑ Standing
❑ Sitting
OTHER SKILLS - Please list:
SUPERVISOR
❑ CDL
❑ Class A
❑ Class B
PAY P/HOUR
POSITION
REASON FOR LEAVING
TO
I hereby authorize you and all former employers, and others given by me as a reference, to answer all questions and to give all information in connection with this application or in any way concerning me. I
agree, if employed by you, that if ever I make claims against you for personal injuries, upon your request I shall submit to drug screens and examinations by physicians of your selection. Your employment of me
may be terminated by you at any time without any liability to me except for wages and salary as have been earned by me at the date of such termination. I understand that it is my responsibility to notify you of
my availability on a weekly basis at a minimum, and if I do not, I will be considered unavailable for work.
SIGNATURE
EDUCATION
NAME OF SCHOOL
DATE
DEGREE
GRADUATED? HAVE YOU EVER WORKED FOR OR APPLIED WITH A TEMPORARY SERVICE? ❑ YES ❑ NO
IF YES, PLEASE LIST THE FIRMS AT WHICH YOU WORKED AS A TEMPORARY.
Firm Names & Addresses:
I hereby authorize you and all former employers, and others given by me as a reference, to answer all questions and to give all information in connection with this application or in any way concerning me. I
agree, if employed by you, that if ever I make claims against you for personal injuries, upon your request I shall submit to drug screens and examinations by physicians of your selection. Your employment of me
may be terminated by you at any time without any liability to me except for wages and salary as have been earned by me at the date of such termination. I understand that it is my responsibility to notify you of
my availability on a weekly basis at a minimum, and if I do not, I will be considered unavailable for work.
SIGNATURE
DATE
Window Envelopes
Your Name & Logo Here
1111 Any Street
Any City, XX 12345
for Checks, Invoices,
and Statements
Security Envelopes available
WEEK ENDING DAT (SUN)
Your Company Name
CLIENT
It is understood that the undersigned will not entrust Your Company Name
employees with unattended premises or any part thereof, handling of cash, negotiables or other valuables without written permissions from Your Company Name
and then only when an employee’s specific duties necessitate such activity.
REPORT TO
SOCIAL SECURITY NUMBER
TIME IN
NOTE: 4 HOUR DAILY MINIMUM ON ALL ASSIGNMENTS.
Signature below constitutes full acceptance of all information on form.
TIME OUT
LESS LUNCH
PERIOD
TOTAL HOURS
MON.
CLIENT - Authorized Signature of Company Representative
TUE.
Sign here:
DRAW LINE
WED.
Firm:
THU.
CLIENT - Please write total hours in words below.
Is this employee’s assignment completed in full?
EMPLOYEE MUST SIGN THIS FORM
SAT.
❑ No
IMPORTANT
SUN.
I certify that these hours were worked by me during the week ending shown above,
and were properly verified by an authorized representative of the customer.
Employee sign here:
THROUGH DAYS
FRI.
❑ Yes
• Your company logo
• Various type styles
• Your choice of custom ink colors
• Guaranteed software compatibility
• Professional in-house graphics
• Rush order services available
EMPLOYEE NAME (PRINT)
Show hours to nearest 1/4 hour (.25)
NOT WORKED
Employer’s Name and Address
TOTAL HOURS
FOR WEEK
1. Be certain front copy is complete and
Intact ToYour Company Name
legible. Week endingBLUE/Customer
date mustCopy
be- WHITE/Mail
indicated
and the form signed by you.
TO RECEIVE YOUR PAYCHECK, THIS
CARD MUST BE RECEIVED BY YOUR
COMPANY NAME NO LATER
THAN MONDAY AT 5:00 P.M.
We agree that if our firm should hire the above named employee within 12 weeks
(clerical / industrial) without agreement from Your Company Name we will pay Your
Company Name liquidated damages.
COATS Laser Forms Feature:
USE LETTER
POSTAGE
MAIL
IMMEDIATELY
TO INSURE
PROPER
PAYMENT
2. If you have changed your address, notify us
immediately.
3. Contact YOUR COMPANY NAME any day
you are unable to report for work and also as
soon as your assignment is completed or YOUR
COMPANY NAME will assume you are not
available for work.
4. Use a separate time sheet for each assignment and for each week’s work.
YOUR COMPANY NAME
YOUR ADDRESS
YOUR ADDRESS
Time Cards
2, 3 and 4 part available
5. If desired you may fax your signed time
card to: 123-4567. Please call our office to confirm your fax was successfully received.
Call Toll Free 1 .877.9 1 3.8 5 00 • Fax 1 . 7 5 7 . 4 3 1 . 0 9 9 2
Your COATS Authorized Forms Provider
P R I N T I N G
Laser Invoice
).6/)#%
Your Name & Logo Here
1111 Any Street
Any City, XX 12345
(999) 999-9999 Phone
(999) 999-9999 Fax
Any Bank Name
with Remit To Stub
0/.UMBER
#USTOMER)$
THIS DOCUMENT HAS A COLORED BACKGROUND, A MICROPRINT SIGNATURE LINE AND BLEED THRU NUMBERING.
)NVOICE
)NVOICE$ATE
7EEKENDING$ATE
Payroll & AP Checks
000001
Any City, XX 12345
Your Name & Logo Here
12-345
1111 Any Street
Any City, XX 12345
(999) 999-9999 Phone
AMOUNT
DATE
67
$
PAY
TO THE
ORDER OF
COATS SQL
AUTHORIZED SIGNATURE
2EFERENCE
$ESCRIPTION
MP
!MOUNT
0AGE
4OTAL$UE
Laser Statement
0LEASERETURNTHISPORTIONWITHYOURPAYMENT$ISREGARDTHISNOTICEIFPAYMENTHASBEENMADE
0/.UMBER
#USTOMER)$
)NVOICE
)NVOICE$ATE
with Remit To Stub
7EEKENDING$ATE
2%-)44/
THIS DOCUMENT HAS A COLORED BACKGROUND, A MICROPRINT SIGNATURE LINE AND BLEED THRU NUMBERING.
Any Bank Name
Any City, XX 12345
12-345
67
Your Name & Logo Here
1111 Any Street
Any City, XX 12345
(999) 999-9999 Phone
000001
AMOUNT
DATE
$
STATEMENT
).6/)#%
4/4!,
PAY
TO THE
ORDER OF
Your Name & Logo Here
MP
AUTHORIZED SIGNATURE
Customer ID
Statement Date
Payroll & AP
Checks
JUST FOLD
COATS Standard
Date
Invoice #
Description
Charges
Payments
Balance
Your Name & Logo Here
Current
30 Days
60 Days
90 Days
120 Days
Amount Due
Please return this portion with your payment. Disregard this notice if payment has been made.
Customer ID
REMIT TO:
Statement Date
STATEMENT
TOTAL
Copy B To Be Filed With Employee’s
Federal Tax Return
a Control number
2004
OMB No.
1545-0008
1 Wages, tips, other comp.
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
Employer
number
__ b__
__ __ID__
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
c Employer’s name,
address, and ZIP code
,
OMB No.
1545-0008
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
c Employer’s name,
address, and ZIP code
,
OMB No.
1545-0008
2
6 Medicare tax withheld
1 Wages, tips, other comp.
OMB No.
1545-0008
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
Employer s State, Local , or File Copy
l
l
2004
2004
1 Wages, tips, other comp.
5 Medicare wages and tips
6 Medicare tax withheld
5 Medicare wages and tips
Employer s State, Local , or File Copy
Copy 2 To Be Filed With Employee’s State
City, or Local Income Tax Return
a Control number
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _
Employer
number
__ __ __ b__
__ __ID__
a Control number
d Employee’s social security number
b Employer ID number
5 Medicare
wages
and tips
d Employee’s social
security
number
e Employee’s name, address, and ZIP code
e Employee’s
address,
c Employer’s name,
address,name,
and ZIP
code and ZIP code
2004
6 Medicare tax withheld
State
Stat
C
7 Social security tips
10 Dependent care benefits
13 Statutory employee
8 Allocated tips
9 Advance EIC payment
11 Nonqualified plans
12a Code
14 Other
Retirement plan
Third-party sick pay
CUSTOMER CODE
JOB CODE
20 Locality name
19 Local income tax
41-1628061
Form W-2 Wage and Tax Statement
This information is being furnished by the Internal Revenue Service.
1111 Any Street
Any City, XX 12345
(999) 999-9999 Phone
(999) 999-9999 Fax
WORK TICKET
COMPANY NAME
DATE
TIME
NUM OF
WORKERS
TICKET NUMBER
REPORT TO
WORK COMP CODE
WORK TICKET COMMENT / PO #
11 Nonqualified plans
3 Social security wages
4 Social security tax withheld
5 Medicare wages and tips
6 Medicare tax withheld
b Employer ID number
c
12d Code
9 Advance EIC payment
11 Nonqualified plans
12a Code
16 State wages, tips, etc.
12b Code
19 Local income tax
17 State income tax
20 Locality name
12c Code
Retirement plan
15
41-1628061
Dept. of the Treasury - IRS
12d Code
L4UP
15 State
’s state
I.D.Be
# Filed
16 With
State wages,
tips, etc.
Copy
2 To
Employee’s
OMB
No. Employer
18 Local wages,City,
tips, etc.
19 Local income
tax
1545-0008
or Local Income
Tax Return
2 Federal income tax withheld
See inst. for box 12
12c Code
15 State Emplr’s state I.D. #
13 Statutory employee 14 Other
18 Local wages, tips, etc.
1 Wages, tips, other comp.
12a Code
12b Code
Third-party sick pay
7 Social security tips
8 Allocated tips
10 Dependent care benefits
a Control number
17 State income tax
State
20 Locality name
2004
Em
OMB No.
1545-0008
1 Wages, tips, other comp.
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
5 Medicare wages and tips
6 Medicare tax withheld
b Employer ID number
C
c
FORM L4UPR
c Employer’s name, address, and ZIP code
c Employer’s name, address, and ZIP code
OTHER
CONTACT PHONE #
2004
9 Advance EIC payment
8 Allocated tips
14 Other
Form W-2 Wage and Tax Statement
Dept. of the Treasury - IRS
Third-party sick pay
Copy C For EMPLOYEE’S RECORDS
(See Notice to Employee on back of Copy B.)
a Control number
JOB SITE
Retirement plan
17 State income tax
16 State wages, tips, etc.
18 Local wages, tips, etc.
Your Name & Logo Here
13 Statutory employee
12c Code
12d Code
15 State Emplr’s state I.D. #
7 Social security tips
d Employee’s social security number
10 Dependent care benefits
See inst. for box 12
e Employee’s name, address, and ZIP code
12b Code
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _
Continuous
Work Tickets
d Employee’s social security number
d Employee’s social security number
e Employee’s name, address, and ZIP code
e Employee’s name, address, and ZIP code
15 State
Stat
Copy 2 To Be Filed With Employee's State, City, or Loca
FOR OFFICE USE ONLY
EMPLOYEE NAME
HOURS
HARD BOOT GLOVES
WORKED
HAT
(TO 1/4 HOUR)
OTHER EQUIPMENT
TRANS INITIAL
4 HOUR MINIMUM (PER PERSON)
IMPORTANT
7 Social security tips
10 Dependent care benefits
13 Statutory employee
DO NOT GIVE WORKERS ANY CASH
CUSTOMER RETAIN TOP WHITE SIGNED
COPY ONLY
DO YOU NEED WORKERS
TO RETURN?
8 Allocated tips
9 Advance EIC payment
11 Nonqualified plans
12a Code
14 Other
Retirement plan
Third-party sick pay
16 State wages, tips, etc.
19 Local income tax
7 Social security tips
8 Allocated tips
10 Dependent care benefits
13 Statutory employee
12c Code
Retirement plan
11 Nonqualified plans
14 Other
18 Local wages, tips, etc.
See inst. for box 12
c E
12c Code
12d Code
15 State Emplr’s state I.D. #
17 State income tax
20 Locality name
9 Advance EIC payment
12a Code
12b Code
Third-party sick pay
12d Code
15 State Emplr’s state I.D. #
18 Local wages, tips, etc.
See inst. for box 12
12b Code
16 State wages, tips, etc.
19 Local income tax
17 State income tax
20 Locality name
15 State
❑ YES
DATE
❑ NO
NO. OF WORKERS
TIME NEEDED
Remarks:
PRINT NAME AND TITLE
41-1628061
Form W-2 Wages and Tax Statement
Dept. of the Treasury - IRS
This information is being furnished by the IRS. If you are required to file a tax return, a negligence
penalty/other sanction may be imposed on you if this income is taxable and you fail to repeort it.
Laser W2s
and Envelopes
AUTHORIZED SIGNATURE
Total Hours:
CUSTOMER AGREES TO THE TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE HEREOF AND CERTIFIES
THAT THE LISTED EMPLOYEES HAVE SATISFACTORILY PERFORMED SERVICE FOR HOURS SHOWN.
Misc. Tax Forms
Also Available
ww w.brothersp rinting u sa.com
Form W-2 Wages and Tax Statement
41-1628061
Important Tax Return Document Enclosed
Stat
Dept. of the Treasury - IRS
L4UP
Copy 2 To Be Filed With Employee's State, City, or Loca
Standard Ink Colors - colors will vary when printed
PMS 423
PROCESS
BLACK
REFLEX
BLUE
PROCESS
BLUE
PMS 209
PMS 314
WARM
RED
PMS 300
PMS 185
PMS 348
PMS 342
PMS 208
PMS 471
PMS 151
PMS 201
PMS 175
PMS 464
PMS 281
Let Brothers Printing
Be Your Complete Printing Source!
Printing:
• Invoices
• Statements
• Applications
• Time Cards
• I9 Forms
• Employee Handbooks
• Brochures
• Business Cards
• Envelopes
• Labels - Singles & Rolls
• Letterhead
• NCR Sets
Business Forms & Machines:
• Checks - Laser & Continuous
• Direct Deposit Vouchers
• Group Time Sheets
• Presentation Folders
• Labels - Laser & Continuous
• Shredders
Promotional Products:
• Pens & Pencils
• Coffee Mugs
• Key Chains
• Post-It Notes
• Mouse Pads
• Stress Balls
• Logo Throws
• Water Bottles
• Golf Balls
• Golf Tees
• Rulers
• Plastic Cards
• Calendar Cards
• Apparel
• Shirts - Embroidered
• Shirts - Silk Screened
Call Toll Free 1 .8 77 .9 13 .8 50 0 • Fax 1 . 7 5 7 . 4 3 1 . 0 9 9 2
3320 Virginia Beach Blvd, Virginia Beach, VA 23452
Phone (757) 431-2656 • Fax (757) 431-0992
Toll Free 1-877-913-8500
P R I N T I N G
Bill to address:
Ship to address:
FORM
250
500
1,000 2,000 3,000 4,000 5,000
INVOICE *
$62.30
$93.10 $124.10 $238.58 $342.99 $457.03 $547.00
STATEMENTS *
$62.30
$93.10 $124.10 $238.58 $342.99 $457.03 $547.00
CLERICAL APPLICATION*
$105.38 $139.75 $195.88 $313.86 $465.06 $617.41 $746.85
INDUSTRIAL APPLICATION*
$105.38 $139.75 $195.88 $313.86 $465.06 $617.41 $746.85
$72.16
I-9 FORM
REGULAR ENVELOPES *
SECURITY ENVELOPES *
QUANTITY
ORDERED
FORM
PRICE
$95.07 $136.31 $266.90 $397.48 $528.06 $658.65
$77.55 $109.95 $208.33 $312.50 $393.52 $474.54
$84.55 $123.96 $236.34 $354.51 $449.54 $544.56
(for Checks, Invoices, and Statements)
CHECKS**
Please send a Voided Check and indicate the
Starting Number and Color Choice below:
Starting # ___________ Color ____________
500
1,000
2,000
3,000
5,000
7,500
10,000
$242.35 $261.60 $344.09 $407.44 $596.09 $761.70 $927.18
1500
3000
6000
TIME CARDS - 2 PART*
$257.73 $382.59 $726.23
4 - PART ALSO AVAILABLE
TIME CARDS - 3 PART*
$352.14 $520.25 $1010.42
PLEASE CALL FOR QUOTE
WORK TICKETS*
PLEASE CALL FOR QUOTE
Prices above are for black imprint only. A $42.00 color charge, per color, is required when using
an imprint color other than black. There is NO ADDITIONAL CHARGE for Black Ink.
**Check pricing includes any of the standard colors (request a standard ink chart).
*
Also, ADDITIONAL RUN CHARGES APPLY WHEN MORE THAN ONE COLOR IS REQUIRED.
ARTWORK CHARGES APPLY.
A PREPAYMENT FORM WILL BE SENT UPON ARTWORK APPROVAL.
OTHER
CHARGES
FREIGHT
TOTAL
SUB
TOTAL
Once we have approved artwork, we will request credit card
information. A charge will be made to the supplied account at
that time for all documents ordered, any additional charges
(ie: ink and additional color charges) and artwork. Artwork is
charged at a rate of $60 per hour, billed on a .25 hour basis.
Once your order has been completed and shipped, a second
charge will be made to your supplied credit card for exact
shipping charges.
If you order over $1,000.00 worth of forms, we will print your company logo
and information in your choice of one color at no charge!
Please call Glenn, Patty, Reanna or Jeana with any questions about ordering your forms: 1.877.913.8500
04/15/16
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