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Featuring a wide variety of business documents for immediate shipment Stock Products

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Featuring a wide variety of business documents for immediate shipment

Stock Products

PXL-CAT-12-10.indd 1 12/14/09 3:06 PM

PMP-101 – 9 1/2”x 5 1/2”4 part, 1-way insert, thumb notch opening. Hot spot carbon, stuffing feature, grey & teal graphics.

Packaged: 1000/carton Weight: 20#/thousand

PMP-201 – 10”x 5 1/2” 6 part, 2-way insert, thumb notch side opening and top sealing return. Hot spot carbon, stuffing feature, blue & grey graphics.

Packaged: 1000/carton Weight: 29#/thousand

PMP-202 – 10”x 5 1/2” 6 part, 2-way insert, easyZIP™ side opening and top sealing return. Hot spot carbon, stuffing feature, red & grey graphics.

Packaged: 1000/carton Weight: 29#/thousand

Rapid Impulse Mailers

RIM-101 – 9 7/8”x 5 1/2” 3 part, 1-way peel-apart mailer with hot spot carbon, red & grey graphics.

Packaged: 1500/carton Weight: 21#/thousand

RIM-102 – 11”x 6” 3 part, 1-way peel-apart mailer with hot spot carbon, red & grey graphics.

Packaged: 1500/carton Weight: 25#/thousand

RRL-201 – 10”x 5 1/2” 6 part, 2-way insert, thumb notch side opening with top sealing return. Hot spot carbon, stuffing feature, red & grey graphics.

Packaged: 1000/carton Weight: 30#/thousand

for use with impact printersMailer products provide an important business function allowing you to print both message and outgoing address in one pass. You also save time and money – no folding or stuffing is necessary – and you reduce inventory since envelopes are eliminated.

The styles on this page are open format and multi-purpose.

2 Your Forms Professional Can Also Help You Design a Custom Product.

PXL-CAT-12-10.indd 2 12/14/09 3:06 PM

Health Care-for use with medical softwareMedical Mailers designed for compatibility with most current healthcare software on the market.

Your Forms Professional Can Also Help You Design a Custom Product 3

Use with National Medical PAR & PAR/SB

PMM-203 – 12”x 5 1/2” 7 part, 2-way insert, easyZIP™ side opening with top sealing return. Hot spot carbon, stuffing feature, red & blue graphics.

Packaged: 1000/carton Weight: 40#/thousand

PMM-204 – 12 3/8”x 5 1/2”7 part, 2-way insert, easyZIP™ side opening with top sealing return. Hot spot carbon, stuffing feature, blue & black graphics.

Packaged: 1000/carton Weight: 40#/thousand

Use with Medical Manager Software

PMM-205 – 10 1/2”x 5 1/2”6 part, 2-way insert, thumb notch side opening with top sealing return. Hot spot carbon, stuffing feature, teal & grey graphics.

Packaged: 1000/carton Weight: 30#/thousand

PMM-206 – 10 1/2”x 5 1/2”6 part, 2-way insert, easyTAB™ top opening with top sealing return. Hot spot carbon, grey and maroon graphics.

Packaged: 1000/carton Weight: 30#/thousand

Use with Medical Manager Software

PMM-102 – 9 1/2” x 6” 4 part, 1-way insert, thumb notch opening. Hot spot carbon, grey & teal graphics.

Packaged: 1000/carton Weight: 22#/thousand

PMM-202 – 9 1/2” x 6” 6 part, 2-way insert, easyZIP™ side opening with top sealing return, blue & black graphics. Hot spot carbon, stuffing feature.

Packaged: 1000/carton Weight: 30#/thousand

STATEMENT DATE

DESCRIPTIONDATE CHARGES PAYMENTS & CREDITS

ACCOUNT NO .

PAY THIS AMOUNT

PXL-CAT-12-10.indd 3 12/14/09 3:06 PM

PAR-401 – Friendly Reminder, 10”x 4 1/4” 3 part, 1-way peel-apart. Hot spot carbon, reflex blue graphics.

Packaged: 1500/carton Weight: 17#/thousand

PAR-402 – Past Due Notice, 10”x 4 1/4”3 part, 1-way peel-apart. Hot spot carbon, PMS purple graphics.

Packaged: 1500/carton Weight: 17#/thousand

PAR-403 – Final Notice, 10”x 4 1/4”3 part, 1-way peel-apart. Hot spot carbon, PMS red 185 graphics.

Packaged: 1500/carton Weight: 17#/thousand

Open Format/MD Versa Software

PMM-207 – 11”x 5 1/2” 6 part, 2-way insert, thumb notch side opening with top sealing return envelope. Hot spot carbon, stuffing feature, grey & red graphics.

Packaged: 1000/carton Weight: 33#/thousand

Medi-Soft Software

PMM-208 – 11 x 5 1/2” 6 part, 2-way insert with thumb notch side opening and top sealing return envelope. Hot spot carbon, teal & mauve graphics.

Packaged: 1000/carton Weight: 33#/thousand

Health Care-for use with medical software

4 Your Forms Professional Can Also Help You Design a Custom Product.

Accounts Receivable-designed with attention-getting graphics These forms can also be used with National Medical Software.

We carry a full line of healthcare forms. For mailer products compatible with software not shown here, consult with your sales representative. For HCFA forms see page 9 of this catalog.

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Your Forms Professional Can Also Help You Design a Custom Product 5

Continuous forms listed are all 9 1/2” x 11.” Call for information about continuous 14” products. All two part products are on carbonless papers either white/white (W/W) or white/canary (W/C).

CMS 1500 – Laser Sheet Products

Style No. Version Description

CL811BC 08/05 One part, w/black 1500, scannableCL811 08/05 One part, all red, not scannable

CMS 1500 – Continuous Products

Style No. Version Description

CC911BC 08/05 One part, w/black 1500, scannableCC911 08/05 One part, all red, not scannableCC911BC-WW 08/05 Two part, (W/W) w/black 1500, scannableCC911BC-WC 08/05 Two part, (W/C) w/black 1500, scannableCC911-WW 08/05 Two part, (W/W) all red, not scannableCC911-WC 08/05 Two part, (W/C) all red, not scannable

Unit Sets

Style No. Version Description

CSBC-WC 08/05 Two part, (WC) w/black 1500, scannable

Carbonless papers, white/canary (W/C)

Envelope

Style No. Description

LG-1500 9x13 Claim Form Envelope

CMS (Formerly known as HCFA)Did you know the most widely used business form in the United States is the CMS 1500? In fact, anyone billing a health insurance company for products or services is required by the Centers for Medicare & Medicaid Services (formerly know as

Health Care Finance Administration) to submit a claim on a CMS-1500 form.

We offer a wide variety of government mandated and approved forms for the health care industry in cut sheet, continuous and unit set formats.

CC911BC

CC911

CC911BC-WW

CC911BC-WC

CC911-WW

CC911-WC

CL811CL811BC

CSBC-WC

LG-1500

PXL-CAT-12-10.indd 5 12/14/09 3:07 PM

6 Your Forms Professional Can Also Help You Design a Custom Product.

Software Compatibility Guide & Cross ReferencePrintXcel Software Common Industry References RIM-101 HP1-406 GG303 RIM-102 HP1-401 GU301 RRL-201 HP2-606 GG603

PMP-101 MPI-406 G-1500 (1 way) G-1500 (2 way) PMP-201 MP2-602 PMP-202 MP2-601 MP2-604

PMM-102 Dr. Office Manager AR1-406 H1694 DM001 PMM-202 Dr. Office Manager AR2-606 H2694 HS601 DM001 PMM-203 National Medical PAR & PAR/SB HC2-701 HS603 PMM-204 Nat’l Medical Upgrade of PAR/SB HC2-702 HS605 PMM-205 Medical Manager PMM-206 Medical Manager PMM-207 Open Format/MD Versa MP2-609 G2510 DM005 PMM-208 Medi-Soft HC2-601 H2510 DM003 HC2-607 H2511

PAR-401 Nat’l Medical Friendly Reminder HC1-401 PAR-402 Nat’l Medical Past Due Notice HC1-402 X1402 PAR-403 Nat’l Medical Final Notice HC1-403

Rapid Impulse Message

Multi- Purpose

Health Care

Accounts Receivable

Pre-printed check shells designed for use with non-impact technology. You can save time and money by imprinting variable information on these base stock products. Perfect for small accounts, you can reduce pre-printed inventories or utilize as fill-in orders. These generic forms can also be used as Direct Deposit Notices, rebate checks or coupons.

And since they are not personalized with MICR lines or bank information, they have no monetary value until you image them, reducing your chances of liability.

LAzeRStoCk™Checks In Top Panel

Order No. O.A. Size Perforation Color

3570B1 8-1/2” x 11” 3-1/2” from top Blue3570R1 7” from top Red3570G1 Green

3500B1 8-1/2” x 11” 3-1/2” from top Blue3500R1 Red3500G1 Green

3673B1* 8-1/2” x 11” 3-2/3” from top Blue3673R1 7-1/3” from top Red3673G1 Green

3600B1 8-1/2” x 11” 3-2/3” from top Blue3600R1 Red3600G1 Green

*Styles indicated with an asterisk are also available on TonerGrip™ papers. Just add a “T” as the first character in the style name.

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Your Forms Professional Can Also Help You Design a Custom Product 7

Check In Middle Panel

Order No. O.A. Size Perforation Color

3570B2 8 1/2” x 11” 3-1/2” from top Blue3570R2 7” from top Red3570G2 Green

3673B2* 8 1/2” x 11” 3-2/3” from top Blue3673R2 7-1/3” from top Red3673G2 Green

Check In Bottom Panel

Order No. O.A. Size Perforation Color

3570B3* 8 1/2” x 11” 3-1/2” from bottom Blue3570R3 7” from bottom Red3570G3 Green

3673B3* 8 1/2” x 11” 3-2/3” from top Blue3673R3* 7-1/3” from top Red3673G3 Green

Check In All Panels

Order No. O.A. Size Perforation Color

3570BA 8 1/2” x 11” 3-1/2” from top Blue3570RA 7” from top Red

3673RA 8 1/2” x 11” 3-2/3” from top Red 7-1/3” from top

LAzeRStoCk™

SeCuRity GuARd™

• Specialty Papers: These features include brownstain chemical reactants to detect attempts at erasure or chemical alterations, and invisible fluorescent fibers that are revealed under special “black lights.”

• Void Pantograph: The check background contains a pattern that reveals the word “Void” if attempts are made to copy this check on most copiers or scanners that are in use today.

• Warning Endorsement: The standard endorsement backer alerts the receiver to check for the security features contained in the check to identify it as an original document. In addition, the endorsement lines are microprinted with the word “Security Guard” which is visible when properly magnified, but appears distorted if copied.

• Warning Band Border: The border message alerts the receiver of the document to check for the Security Guard features contained in the check.

All Lazerstock products include the following Security Guard.™ Features designed to add protection to your negotiable documents

PXL-CAT-12-10.indd 7 12/14/09 3:07 PM

8 Your Forms Professional Can Also Help You Design a Custom Product.

Since 1996, VersaSeal has been the ideal print-to-mail solution for all types of business using non- impact technology. The system utilizes a pressure-activated adhesive so no glue, heat or water is needed. And because VersaSeal uses patented and proprietary glue patterns and chemistry, these products will perform flawlessly regardless of the printer or the folder sealer being used.

All of the products shown are ideal for small users, test runs, fill-in orders, or special applications.

All styles are shrink-wrapped in packages of 500 and packed 1,000 forms per carton. They are on the shelf available for immediate shipment.

Cut Sheet Window C-Fold Check- 8 1/2 x 11”

WC811B3 – 8 1/2”x 11”– Blue pantograph in bottom panel

Prints on 28# MOCR bond designed specifically for use in pressure seal systems. Back printing includes an artificial watermark and REG CC backer. Bottom panel includes a hidden “void” feature design.

Cut Z-Fold Check- 8 1/2 x 11”

• Z811B2-O – Blue pantograph in center panel—original format

• Z811B2-E – Blue pantograph in center panel—enhanced format

• Z811R2-O – Red pantograph in center panel—original format

• Z811R2-E – Red pantograph in center panel—enhanced format

• Z811G2-O – Green pantograph in center panel—original format

• Z811G2-E – Green pantograph in center panel—enhanced format

• Z811YBP-2 – Prismatic Yellow/Blue pantograph in center panel—enhanced version only

• Z811P2-O – Prismatic Blue/Green pantograph in center panel—original version

• Z811P2-E – Prismatic Blue/Green pantograph in center panel—enhanced version

• Z811CAN – Prismatic Blue/Green pantograph in center panel—enhanced and Canadian Check Compliant face and back NEW

All styles print on 28# MOCR bonds designed specifically for pressure seal applications. All styles have back printing featuring artificial watermarks and Reg CC backers. Face printing includes a hidden “void” pantograph in the center panel. Additional security features on our new enhanced versions include microprinting, warning band, and padlock icon.

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THIS DOCUMENT HAS A VOID PANTOGRAPH, MICROPRINTING AND AN ARTIFICIAL WATERMARK.

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SECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDO

11C-VG

REV.6.06

Rev. 9/01/06

PATENTS 4,210,346; 4,227,720; 4,310,180; 5,197,765; 5,340,159

Style WC

811B3

Reorder V

ersa

Seal®

U.S. Pat.# 6,095,407

®

*See Reverse Side For Easy Opening Instructions*

Reorder V

ersa

Seal®

Style Z811R

2

THIS DOCUMENT HAS A VOID PANTOGRAPH, MICROPRINTING AND AN ARTIFICIAL WATERMARK.

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PATENTS 4,210,346; 4,227,720; 4,310,180; 5,197,765; 5,340,159

SECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTSECURITYDOCUMENTS

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U.S. Pat.# 6,095,407

VeRSASeAL

*See Reverse Side For Easy Opening Instructions*

PATENTS 4,210,346; 4,227,720; 4,310,180; 5,197,765; 5,340,159

U.S. Pat. no. 6,095,407 R

eorder Versa

Seal®

Style Z811B

2-O

Z811B2-E

Z811R2-O

Z811G2-E

Z811R2-E

Z811B2-O

Z811G2-O

Z811YBP-2Z811P2-O

Z811P2-E Z811CAN

WC811B3

PXL-CAT-12-10.indd 8 12/14/09 3:08 PM

Your Forms Professional Can Also Help You Design a Custom Product 9

RC814BA

• Z814B2-O – Blue pantograph in center panel—original format

• Z814B2-E – Blue pantograph in center panel—enhanced format

• Z814G2 – Green pantograph in center panel— enhanced version only

• Z814P2 – Prismatic Blue/Green pantograph in center panel—original version only

• X814B2-O – Blue pantograph in center panel. Folds unevenly at 5 1/4” and 10 1/2” to provide more print area—original version

• X814B2-E – Blue pantograph in center panel. Folds unevenly at 5 1/4” and 10 1/2” to provide more print area—enhanced version

Cut Sheet C-Fold – 8 1/2”x 11”

• C81100 – All purpose form, no tint

• C811P3 – Check with prismatic Blue/Yellow void pantograph in bottom panel

Cut Sheet Z-Fold, All Purpose – 8 1/2”x 11”

• Z811BA – All purpose form with blue tint, no security features

• Z81100 – All purpose form, no tint

• Z811Blank – All purpose form, blank face and back

All Purpose – 8 1/2”x 14”

• Z81400 – All purpose form, no tint

• Z814BA – All purpose form, blue tint

• X814BA – All purpose form, blue tint with uneven fold perfs at 5 1/4” and 10 1/2” for additional print area.

®

Same product features as shown for 11” products.

Prints on 28# MOCR bond paper designed for pressure seal applications.

Cut Sheet V-Fold– 8 1/2”x 11”

• V81100 – All purpose form on 28# ledger. No inside tint, grey security screen outside.

• RC814BA – All purpose form with no tint. Two Way Mailer – 8 1/2”x 14” C-Fold on 28# bond

Cut Sheet Z-Fold Check Format – 8 1/2”x 14”

Z814B2-O

X814B2-O X814B2-E

Z814B2-E

Z814G2

Z814P2

C81100 C811P3

Z811BAZ81100

Z811Blank

Z81400Z814BA X814BA

VeRSASeAL

V81100

PXL-CAT-12-10.indd 9 12/14/09 3:08 PM

Ordered by

P.O. Acct No.

Detach and fax or mail your order

10 Your Forms Professional Can Also Help You Design a Custom Product.

Style No. Description No. Ctn Qty/Ctn Total Qty Price/M Total Price

Please have a sales rep call me. Signature Required Date

Return PolicyReturns will be authorized under the following circumstances:

• Stock forms may only be returned if the form has not been revised since the order was placed.

• There is a 15% restocking fee plus shipping costs for items ordered in error

• Credit will not be given for partial cartons, opened packages or product damaged in return shipping

• Items filled in error by the plant will be exchanged at no cost to the customer if we are notified within 30 days of the original order date.

• Should you wish to return an item, please contact your sales service representative first. Our receiving department cannot guarantee acceptance of returned product without prior knowledge.

• All stock products will ship within 24 hours of order receipt, unless otherwise specified.

order Form

Phone Fax Mail Online

Four Ways To Order

Ship to

PXL-CAT-12-10.indd 10 12/14/09 3:08 PM

Packaging information

Your Forms Professional Can Also Help You Design a Custom Product 11

Please have a sales rep call me. Signature Required Date

Style Number Weight/M Qty/Carton Weight/Carton

RIM-101 21 1500 31 RIM-102 25 1500 37 RRL-201 30 1000 30

PMP-101 20 1000 20 PMP-201 29 1000 29 PMP-202 29 1000 29

PMM-102 22 1000 22 PMM-202 30 1000 30 PMM-203 40 1000 40 PMM-204 40 1000 40 PMM-205 30 1000 30 PMM-206 30 1000 30 PMM-207 33 1000 33 PMM-208 33 1000 33

PAR-401 17 1500 25 PAR-402 17 1500 25 PAR-403 17 1500 25

CC811BC 14 2500 35 CL811 14 2500 35 CC911BC 12 2500 30 CC911 12 2500 30 CC911BC-WW 20 1000 20 CC911BC-WC 20 1000 20 CC911-WW 20 1000 20 CC911-WC 20 1000 20 CSBC-WC 20 1000 20 PS100L N/A 250 N/A PS100P N/A 500 N/A

All Styles 14 2500 35

WC811B3 16 1000 16 Z811B2 (E & O) 16 1000 16 Z811R2 (E & O) 16 1000 16 Z811G2 (E & O) 16 1000 16 Z811BA 16 1000 16 Z811YBP-2 16 1000 16 Z81100 16 1000 16 Z814B2 (E & O) 19 1000 19 Z814G2 19 1000 19 X814B2 (E & O) 19 1000 19 Z81400 19 1000 19 Z814BA 19 1000 19 X814BA 19 1000 19 C81100 16 1000 16 C811P3 16 1000 16 V81100 16 1000 16 RC814BA 19 1000 19 Z811P2 (E & O) 16 1000 16 Z814P2 19 1000 16

Rapid ImpulseMailersPage 2

Multi-PurposeMailersPage 2

Health CarePage 3-4

Accounts ReceivablePage 4

Lazerstock™ Page 6-7

VersaSeal Page 7-8

CMS Forms(Formerly known as HCFA)Page 5

PXL-CAT-12-10.indd 11 12/14/09 3:08 PM

Revised Jan 2010

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