Checks & Forms 114 Laser Billing Statement Features • Blue or Burgundy • 11 Templates • 81/2" x 11" • 20 lb. White laser bond with micro-perforation for ease of printing, opening, and remittance • Change of address/insurance backprint • 500 per package • Optional: “We accept” – Mastercard/Visa – Mastercard/Visa/Discover – Mastercard/Visa/Discover/American Express backprint Item Number Description Color 500 1,000 2,500 5,000 10,000 RHF1-HCF10-NS26 Generic laser statement Blue $48.53 $72.80 $143.87 $263.47 $518.27 Popular Pick! RHF1-HCF11-NS26 Generic laser statement (MC/VISA) Best Seller! Blue $48.53 $72.80 $143.87 $263.47 $518.27 VWH-HCF14-NS26 Generic laser statement (MC/VISA/DISC) Blue $48.53 $72.80 $143.87 $263.47 $518.27 A. RHF1-HCF15-NS26 Generic laser statement (MC/VISA/DISC/AMEX) Blue $48.53 $72.80 $143.87 $263.47 $518.27 VWH-HCF16-NS26 Generic laser statement Burgundy $48.53 $72.80 $143.87 $263.47 $518.27 VWH-HCF13-NS26 Generic laser statement (MC/VISA) Burgundy $48.53 $72.80 $143.87 $263.47 $518.27 B. VWH-HCF12-NS26 Generic laser statement (MC/VISA/DISC) Burgundy $48.53 $72.80 $143.87 $263.47 $518.27 RHF1-HCF17-WM26 Generic laser statement (No back print) Blue $48.53 $72.80 $143.87 $263.47 $518.27 VWH-HCF18-NS26 Generic laser statement (No back print) Blue $48.53 $72.80 $143.87 $263.47 $518.27 VWH-HCF19-NS26 Generic laser statement Blue $48.53 $72.80 $143.87 $263.47 $518.27 VWH-HCF20-NS26 Generic laser statement, MC/VISA Blue $48.53 $72.80 $143.87 $263.47 $518.27 Item Number Description Size 500 1,000 2,500 5,000 10,000 C. ECW-B52-B-NS26 #9 Double window envelope, self-seal 87/8" x 37/8" $246.13 $370.93 $741.87 $1,336.40 $2,511.60 D. ECW-B84-B-NS26 #9 Double window envelope, gum-seal 87/8" x 41/16" $81.46 $121.33 $282.53 $539.07 $989.73 (R) Production time: 1 working day. 2,000 per carton. Medical Laser Billing Statement Double Window Envelope PLEASE RETURN TOP PORTION WITH YOUR PAYMENT, RETAIN BOTTOM PORTION FOR YOUR RECORDS WLCS107-BK Please box if above address information is incorrect & indicate changes on reverse side. Please see back of form WE ACCEPT B. A. C. D. Front Back PLEASE RETURN TOP PORTION WITH YOUR PAYMENT, RETAIN BOTTOM PORTION FOR YOUR RECORDS WLCS107-BK bove address information is incorrect & indicate changes on reverse side. Please see back of form WE ACCEPT Medical Laser Billing Statements
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