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Deposit Tickets
Prequalified Business Deposit
DESCRIPTION
Two parts carbonless: 26# White CB and 15# Canary CF
Standard shrink wrapped in 250's
SIZE
3 3/8" x 8 1/4"
CHOICE OF VARIABLE HEADINGS - NO EXTRA CHARGE
Account name
Account number - no consecutive numbering
QUANTITIES
Multiples of 1,000
PRICING
1,000 - $104.75
2,000 - $166.80
3,000 - $220.35
4,000 - $274.56  
5,000 - $317.70 
Additional 1,000 over 5,000 - $62.00 
Please enter the required information to be displayed on the form:
1) Account name (not required - leave blank if unused)
Account Name :
2) Account number (rot required - leave blank if unused)
Account Number :
3) Enter the bank name and address to appear on the form:
Bank Name :
Address :
City :
State :
Zip :
4) 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.

Auxiliary ON-US
(fields 45-65)

Transit Number
(fields 33-43)

ON-US
(fields 14-31)

Amount
(fields 1-12)
Quantity :
(Multiples of 1,000)		 Each additional 1,000 over 5,000 - $62.00
Item Total : $0
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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