Falls Cities Printing - ONLINE Ordering

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Account Correction Forms
Advice of Charge DESCRIPTION 2-Part Carbonless Colors: White 26#, Canary 15# SIZE 3 3/8" x 7" (6 1/4" detached) VARIABLE INFORMATION Bank name and address MICR QUANTITIES Multiples of 1,000 PRICING 1,000 - $104.00 2,000 - $159.81 3,000 - $214.90 4,000 - $270.56 5,000 - $317.00 Additional 1,000 over 5,000 - $45.00

Please enter the required information to be displayed on the form:
1) Enter the bank name and address to appear on the form:

Bank Name :

Address :

City :

State :

Zip :

2) MICR Encoding (for more info on entering the MICR line, click here)
When a space is required, type an "X" in the space. Leave any unused fields blank.


Transit Number (fields 33-43)	ON-US (fields 14-31)	Amount (fields 1-12)

Quantity :
(Multiples of 1,000)

Each additional 1,000 over 25,000 - $45.00

Item Total :

Any Special Instructions for this form :

Contact Name :

Company Name :

Address :

City :

State :

Zip :

Email Address :

Phone Number :

Purchase Order # :

Additional Comments :
(If you have any other comments or requests, enter them here)

When finished, click the Submit button below to send your order for this product to Falls Cities Printing.

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