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1994-01-01
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171 lines
ZIPPER Payroll / DELUXE Order Form
1: PERSON ORDERING: _________________________ Title: __________________
Firm Name: _____________________________ Phone: (___) _____-_________
Street Address: ______________________________________________________
City: _________________________ State: _________ Zip: ____________
2: SHIP TO: (Fill in only if different from person placing order.)
Recipient Name: ____________________________ Title: __________________
Firm Name: ____________________________________________________________
Street Address: _______________________________________________________
City: ______________________________ State: _________ Zip: _________
3: ORDER INFORMATION:
Product Qty Description No. of Check Deluxe Start Unit Total
Number Parts Backgrnd Logo No. Price Price
Color Number
--------------------------------------------------------------------------
_______|_______|____________|______|_________|______|________|_____|______
_______|_______|____________|______|_________|______|________|_____|______
_______|_______|____________|______|_________|______|________|_____|______
_______|_______|____________|______|_________|______|________|_____|______
.. Orders for checks require a sample marked "VOID" for MICR encoding.
.. Available in blue, green, tan, yellow or antique
.. Choose 1-, 2-, or 3-part checks
__ Antique Finish Checks add $10/thous. 500 order also add $10.00 $_______
__ LOGO ARTWORK ATTACHED $25 charge for your logo* $_______
__ $3.95 CHARGE for using standard logos available from Deluxe $_______
SUB-TOTAL $_______
TAX ** $_______
THANK YOU TOTAL $_______
PAYMENT OPTIONS:
__ Check or money order enclosed, made payable to Deluxe Computer Forms.
__ Bill me later. We have an account with Deluxe. (Minimum $25 order.)
__ Please open an account for us. Minimum $25 order. Attached two current
trade references and fill in below.
Bank Name: _____________________ Acct No: _______________________
Bank Phone: (___)___-____ ext.___
Please bill my __ VISA __ MasterCard __ American Express
Cardholder Name |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
Account Number |_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
Exp. Date |__|__|__|__|
X__________________________________
Authorized Signature MAIL TO:
Deluxe Business Systems
3660 Victoria St. No.
Shoreview, MN 55126
Code=T09638
ZIPPER Payroll / DELUXE Prices
=========================================================================
CONTINUOUS FORM CHECKS FOR DOT MATRIX PRINTERS. - Versions 1.0 to 1.6
=========================================================================
Product |----------- Quantity ------------|
Number Description 250 500 1000 2000
-------------------------------------------------------------------------
090973 Check, 1-Part $ 62.50 $ 75.95 $ 98.95 $139.00
" Check, 2-Part 74.50 89.95 127.00 240.00
" Check, 3-Part 79.95 98.95 153.00 295.00
=========================================================================
CONTINUOUS FORM CHECKS FOR DOT MATRIX PRINTERS. - Version 1.7 and later
=========================================================================
Product |----------- Quantity ------------|
Number Description 250 500 1000 2000
-------------------------------------------------------------------------
091004 Check, 1-Part $ 62.50 $ 75.95 $ 98.95 $139.00
" Check, 2-Part 74.50 89.95 127.00 240.00
" Check, 3-Part 79.95 98.95 153.00 295.00
=========================================================================
LASER CHECKS - Version 1.7 and later
=========================================================================
Product |----------- Quantity ------------|
Number Description 250 500 1000 2000
-------------------------------------------------------------------------
081004 Laser Check $ 62.50 $ 77.95 $113.00 $207.00
=========================================================================
WINDOW ENVELOPES FOR LASER AND CONTINUOUS CHECKS -- All versions
=========================================================================
Product |----------- Quantity ------------|
Number Description 250 500 1000 2000
-------------------------------------------------------------------------
091500 Double Window Envelope 25.50 34.50 56.95 99.50
=========================================================================
W-2 FORMS FOR LASER PRINTERS - Version 1.7 and later
=========================================================================
Product |----------- Quantity ------------|
Number Description 30 60 90 150
-------------------------------------------------------------------------
082631 4 Part 23.95 30.95 37.50 50.95
082632 6 Part 31.95 42.50 52.50 72.50
082633 8 Part 35.50 50.95 65.95 95.95
ZIPPER Payroll / DELUXE Prices - Continued
=========================================================================
CONTINUOUS FORM W-2'S -- All versions
=========================================================================
Product |----------- Quantity ------------|
Number Description 25 50 100 150
-------------------------------------------------------------------------
092611 1 Wide, Carbonless 4 Part 22.50 26.95 35.95 44.50
092606 6 Part 25.95 30.95 40.50 49.50
092610 8 Part 30.50 37.50 51.95 66.95
092612 1 Wide, w/ Carbon 4 Part 22.95 26.95 35.50 43.95
092607 6 Part 23.95 29.50 39.50 49.50
=========================================================================
ENVELOPES FOR W-2's -- All versions
=========================================================================
Product |----------- Quantity ------------|
Number Description 25 50 100 150
-------------------------------------------------------------------------
082631 Double Window 7-7/8x5-3/4 11.95 14.50 18.50 22.50
*************** Prices subject to change without notice. ***************
* Additional charge for touchup, typesetting, rearrangement or matching
preset ink colors.
** We are required to charge you state, county, or local sales tax where
applicable. Illinois residents are required to pay a 1% sales tax.
NEW ACCOUNTS: Available with minimum order of $25.00. To open, provide
two credit references (with account numbers), including your bank and one
additional creditor. Terms are net 10 days. State sales tax will be added
to your order where applicable. VISA or MasterCard accepted by phone or
mail. Freight pre-paid.
FREE DELIVERY: We'll pay surface freight if payment is included with your
order (48 contiguous states only). Please include street address with
order. All orders are shipped regular U.P.S. but, at your request, we will
ship by air for an additional charge.
For Assistance call 1-800-328-0304
in Minnesota 1-612-631-8500
in Colorado Springs, CO 1-800-528-8411
Please reference Account Code: T09638
SEND ORDERS TO:
Deluxe Business Systems
3660 Victoria St. No.
Shoreview, MN 55126