Check Us Out Mail-In Order Form

Type your information in the form below. The following information is to contact you only if necessary. Please check Step Four for further instructions prior to sending this order. Thank you.

Please note, we only accept orders for U.S. Banks.

Your Name:

Address:

City:

State & Zip Code:

Evening Phone #:

Daytime Phone #:

Email:

Shipping Address (if different from above)

Note: Unless you tell us otherwise, we will ship orders to the address we print on the checks.

Your Name:

Address:

City:

State & Zip Code:

How did you hear about us? (Be specific)

What style of checks would you like to order and how many?

Please select what you would like to order:

Checks to begin with #:

(Will begin with #1001 if not indicated)

What design style would you like on your checks?

Please select the design style you desire:

Optional Typestyles . . . . . . . . . . . . . add $2.50

(Unless otherwise noted, Block Lettering will be used on checks)

Please select a style:

Personal Expression Line Over Signature . . . . . . . . . . . . . add $2.50

Please, 26 characters only per line (including spaces) - 2 Lines Max
This will appear above the signature line on your checks

Leather Checkbook Cover . . . . . . . . . . . . . add $14.95

Fill out total amount of order in the form below.

Base Total for Checks:

Add $2.50 for Optional Typestyles:

Add $2.50 for Personal Expression Line:

Add $14.95 for Leather Checkbook Cover:

SUBTOTAL:

Sales Tax, CA res. only, add 8.75%:

Shipping and Handling, add $3.95 PER BOX:

Express Service (Priority Mail), additional $6.75:

(takes approx. 2 weeks off turn-around time)

GRAND TOTAL :

Now click "PRINT" on your browser.
This will print out this form and all the information you have typed in above.

Mail this form to:

PO Box 249, San Leandro, CA 94577-0149

510-430-8844 1-800-771-2439

Be sure to include the following items:

1. Voided check or reorder form from current supply (indicating changes).

2. Deposit slip from current supply.

3. Completed order form.

4. Check / money order made payable to �Check Us Out�.

5. New bank account? If you don�t have starter checks, include MICR coded specification sheet from your bank for wallet size.

Allow 4-6 weeks for delivery of checks, cover & register

U.S. Bank coding guaranteed