MICR
Signature Lines One Two Title _____________________ Above Below (Signature Line)
Typeface Helvetica Other ______________________
DISTRIBUTOR INFORMATIONDistributor Name ________________________________________
Contact Person _________________________________________
Address ______________________________________________
City ____________________________ St _______ Zip ________
Phone Number _________________________________________
Email Address _________________________________________
Date ____________________________
Purchase Order ___________________
Proof Yes No
NEW Order
REPEAT Order # _________________
REPEAT Order with Changes
Order # _________________________
Changes ________________________
________________________________
________________________________
Quantity _________________________
NEW ORDER CHOICES(please see the back side for layout, color, pantograph and security options)
Layout A B C D E F G H
Base Color Dk Blue Green Burgundy Brown Teal Process Blue Purple Red Prismatic
Pantograph Design Marble Linen
Paper Security Level One (MICR Bond) Two (Security Paper)
Number of Parts One Two Three(White/20#Canary) (White/20# Canary/20# Pink)
Numbering Standard MICR & Black ArabicsUpgrade Bleed through MICR and red bleed through arabics (add $11.50 FLAT and $2.35/M/PT)
OVERPRINT & BANKING INFORMATION Sample Supplied Software Compatible
Software Name / Version ______________________________
Heading Logo Supplied
Imprint _______________________________________________
______________________________________________________
______________________________________________________
Bank Logo Supplied
Imprint _______________________________________________
______________________________________________________
______________________________________________________
ABA Fraction Starting # _____________________
PROCESSING & SHIPPINGTurnaround 24 Hour - Standard
Same Day - $20.00
Shipping UPS Ground Next Day Air 2nd Day Air 3 Day Select Pick-up
Ship to Same as Heading Other
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_____________________________________
_____________________________________
Packing Sequence Standard AscendingOther ___________
DON’T FORGET!!COMPATIBLE DOUBLE WINDOWENVELOPES FOR YOUR CHECKS(please see the back side for envelope dimensions)
#1 Tinted #3 Tinted Flip and Seal
Quantity ________________________
Order Form
= C= D
Thank you for your order!
Layout H is available only on Level 2 and comes in a Linen Pantograph Design only. Layout H is offered exclusively at our GA plant.
LAYOUT OPTIONS VOID BACKGROUND OPTIONSMarble Void
Linen Void
STANDARD TYPESTYLES
BASE STOCK COLORS
SECURITY FEATURES
1.) VOID PANTOGRAPH2.) MICROPRINT SIGNATURE LINE 3.) PADLOCK ICON4.) CHECK WARNING BORDERS5.) SECURITY BACK PRINTING6.) THERMOCHROMIC PADLOCK ICON7.) COIN REACTIVE INK8.) GHOST PADLOCK WATERMARK BACKER9.) CHEMICAL REACTIVITY10.)TONER ADHESION11.) FLUORESCENT FIBERS12.) BLEED THROUGH MICR NUMBERS13.) BLEED THROUGH RED ARABIC NUMBERS
LEVEL 124# MICR BOND
LEVEL 224# SECURITY BOND
NUMBERING SEQUENCE OPTIONS
COMPATIBLE DOUBLE WINDOW ENVELOPESTinted for Security
All CheckMate orders are packed in convenientsecurity sealed inner cartons.
Order Form Options - Customize your check!
CHECK
CHECK
CHECK
CHECK
CHECK
CHECK
CHECK
4”
3-1/2”
3-1/2”
4”
4”
3-1/2”
3-1/2”
3-1/2”
3-1/2”
4”
3-1/2”
3-1/2”
3-1/2”
3-1/2”
3-1/2”
1/2”
CHECK
3-2/3”
3-2/3”
3-2/3”CHECK
7-1/2”
3-1/2”
Layout A
CHECK
3-1/2”
3-1/2”
3-1/2”
3-1/2”
Layout H
Layout B Layout C
Layout E Layout F Layout G
Layout D
1459 Jamike Ave.Erlanger, KY 41018
www.graphdim.com
