Payee Positive Pay Laser Checks

Bank & CPA Use Only - Click Here
Thank You for your Referral
Your Name  
Your Phone Number  
Your Email  
Who will we be billing?  

     
1) Quantity or Kit
2) What Color Stock
3) Start Number
4) Check Imprint  
Title of Business  
(Account Title Or DBA)

Physical address required for delivery.
If a PO Box is used here, please
add address below in the
Alternate Shipping Area.

Address
City,State, Zip
Phone On Check  
5) Account Information    
Bank Name  
Bank City & State  
Bank Fraction Number  
Bank Routing Number
Bank Account Number  
6) Software Name & Version  
7) Extra Signature Line If so, add text to special instructions box.
8) Logo  
9) Attach Art File
10) Proof Proofs add 3 days to Production Time
11) Collation  
12) Special Instructions

Use this area for additional instruction.
(ex. 2nd signature line info,
logo instructions)

13) Contact Information    
Contact Name at business where product will ship
Contact Phone  
Contact Email  
14) My Representative Is  
15) How Would You Like To Pay  
16) Credit Card Info  
Credit Card #  
Credit Card Exp.  
Name on Card  
17) Promotional Code  
18) Production Rush  
19) Shipping Method  
   

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Click for Alternate Shipping Address
Alt Ship To (physical address only)
Attn  
Address  
City, State, Zip  
     

Click for Ship Notification
Would you like to receive a Ship Notification by email?
   

Click Submit to send your order. A page will follow, which can be printed for your records. Thank you for your order.