Questions? 800-722-2804 / 404-351-2700


QS1 Governmental Solutions
Payroll Check
Check Information

 
Name:
Address 1:
Address 2:
City, State, Zip:
Phone #:
Include Phone Number on Check
Email Address:
Fax #:
Reorder? Check this box if this is a reorder.
Reorder - It's not necessary to fill out the Bank Account Info fields below.
This is a reorder

Bank Account Info

Bank Name (required):
Bank City, State (required):
Bank Phone Number (required):
Click here for information on Bank Routing Number. Bank Routing Number (9 digits): 
Click here for information on Bank Account Number. Bank Account Number (Please use an 'X' to show a space between numbers and a '-' for a dash): 
Click here for information on Bank Fraction Number. Bank Fraction Number (ie. 12-34/567)

Type of Check: QS/1 Data Systems Payroll Check 
Fade Color Choice
Quantity / Cost:
Starting Check Number
Number of Signature Lines:
Comment to be printed above signature Line (default is blank):
Print Company Logo? (Additional $25 one time fee-- JPG, TIF, PCX 300dpi):

 
Special Instructions:

 
Matching Double Window Security Check Envelopes

 

Security Envelopes Type:

Select Quantity/Price:
(Add $8/1,000 for shipping)
(Self-Seal Envelopes Only Sold in Boxes of 1,000)

Shipping Services
 

Expedite Service:

Shipping Method:
Shipping is additional. Click here for a rate & time in transit chart

Contact Information

Contact Name:
Day Time Phone #:

Payment Information

Pay by direct debiting this account
Bill me with Net Terms (Must have already established account)
Pay by Credit Card
Credit Card:
Credit Card #:
Expiration Date:
Same Name, Address and Phone Number as above.
Name:
Billing Address 1:
Billing Address 2:
Billing City, State, Zip:
Phone Number:
Thank you for your order!

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Fast Turnaround
(Your order will ship 1 day after proof is approved)
800-722-2804 / 404-351-2700

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