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- 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: _________
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- 3: ORDER INFORMATION:
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- Product Qty Description No. of Check Deluxe Start Unit Total
- Number Parts Backgrnd Logo No. Price Price
- Color Number
- --------------------------------------------------------------------------
- _______|_______|____________|______|_________|______|________|_____|______
- _______|_______|____________|______|_________|______|________|_____|______
- _______|_______|____________|______|_________|______|________|_____|______
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- .. 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 |__|__|__|__|
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-
- X__________________________________
- Authorized Signature MAIL TO:
-
- Deluxe Business Systems
- 3660 Victoria St. No.
- Shoreview, MN 55126
- Code=T09638
-
-
- ZIPPER Payroll / DELUXE Prices
-
-
- Product |----------- Quantity ------------|
- Number Description 250 500 1000 2000
- -------------------------------------------------------------------------
- 090973 Check, 1-Part $ 47.50 $ 63.50 $ 83.50 $125.00
- " Check, 2-Part 63.50 89.95 131.00 218.00
- " Check, 3-Part 73.95 106.00 168.00 271.00
- 091500 Double Window Envelope 25.50 34.50 56.95 99.50
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- *************** 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.
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-
-
-
- SEND ORDERS TO:
- Deluxe Business Systems For Assistance call 1-800-328-0304
- 3660 Victoria St. No. in Minnesota 1-612-631-8500
- Shoreview, MN 55126 in Colorado Springs, CO 1-800-528-8411
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