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Order Form

Billing Information

Thank you for choosing to place an order with us! Simply fill out the order form below and press the “Submit Order” button once when you are finished. Please note that fields labeled in Bold Red are REQUIRED.

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First Name:
Last Name:
Company Name:
Title at Company:
Address 1:
Address 2:
City:
State:
Zip:
Email:
Phone:
Facsimile:
e-Savings Code:
Comments:
Software Type:
Enter if "Other":
Printer paper type:

Item Information

To add an item to your order, simply select its Quantity/Price, and/or Color. As an added convenience, you can click the name of an item to see its page again before you add it to your order.

PLEASE NOTE: If you view a product's page from one of the links listed below, be sure to use your browser's back button to return to this order form, AND avoid re-entering your information.

Blank Checks

Item Description	Quantity - Price	Color
#40 LaserSecure Blank Laser Printer Checks
#140 LaserSecure Blank Laser Printer Checks
#501 LaserSecure Blank Laser Printer Checks
#502 LaserSecure Blank Laser Printer Checks
#503 LaserSecure Blank Laser Printer Checks
#303 LaserSecure Blank Laser Printer Checks
#34 Blank Laser Printer Check Copy
#142 Blank Laser Printer Check Copy
#512 Blank Laser Printer Check Copy

Pre-printed Checks

Item Description	Quantity - Price	Color
#40P LaserSecure™ Pre-printed Laser Printer Checks
#34P Pre-printed Laser Printer Check Copy
#LR2202 LaserSecure™ Pre-printed Laser Printer Checks
#LR2206 LaserSecure™ Pre-printed Laser Printer Checks
#LR2207 Pre-printed Laser Printer Checks
Continuous Pin-Fed Checks (1-Part Set)
Continuous Pin-Fed Checks (2-Part Set)
Continuous Pin-Fed Checks (3-Part Set)

Forms

Item Description	Quantity - Price	Color
#52 Laser Printer Rent Statements
#520 Laser Printer Rent Statements
#7401 Laser Rent Coupons
#191 Rent Statements
#90 Laser Printer Multi-purpose Form (1-Part Set)
#90 Laser Printer Multi-purpose Form (2-Part Set)
#90 Laser Printer Multi-purpose Form (3-Part Set)
Custom Business Forms	Call us at 1-800-728-5490 for a quote!

Envelopes

Item Description	Quantity - Price
#ENV1 Double Window Envelopes
#ENV-CONT Double Window Envelopes
#ENV-TPR Self Seal Double Window Envelopes for QuickBooks
#ENV-QCK Double Window Envelopes for QuickBooks
#ENV-STD Self Seal Double Window Envelopes
#ENV-2393 Self Seal Double Window Envelopes

Supplies

Item Description	Price	Quantity
Hewlett-Packard MICR Toner Cartridges

Specialty Graphics, Inc.