DCCC-474, Snap-A-Part Dual Purpose Security Check

Quantity and One or Two Part:

* denotes required field

Enter Company Name or Main Line of Text

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Enter P.O. Box or Street Address or 2nd Line of Text

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Enter City, State, Zip or 3rd Line of Text

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Phone, Fax or E-mail or 4th Line of Text

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If you chose a TYPESTYLE. Please enter its ID Code here:

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Choose Optional Imprint Color (Optional. Black will be default if none is selected)

Check Starting Number (001001 will be default if none is chosen)

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Indicate how you will send copy of existing check or starter check for MICR verification*

Optional: Enter Text above signature line

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Would you like 1 or 2 Signature lines?

Consecutive or Reverse Numbering?

Enter 9-digit Routing Number:

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Enter Bank Account Number. Type "S" for spaces, "D" for Dashes, and "C" for Symbols:

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Would you like a proof sent to you prior to printing?

Quantity:

Pricing Information:

Form Features:

Security: Items A & B include a Padlock Warning Box, which lists details of security features:
Security: Microprint border and signature line are readable under simple magnification. On copies, microprinting is virtually unreadable. Signature line becomes a broken line when altered. (Available on Security Checks only):
Background Color: Gray Marble
Check Numbering: Starting Number: Choose a six-digit starting number for your imprinted check at no additional charge. Otherwise, we will start at 001001.
Multi-part color sequence: Colors correspond to sequence and number of parts selected in your order.
Choice of Imprint Colors:
Free Typestyle-Add a font to the main line of text ( NOTE: Arial is the default typestyle if none is selected.
View Available Typestyles-Please Specify by ID Code under Personalization.
Up to 4 lines of imprint.

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