FIS
[pic] INFORMATION TECHNOLOGY, INC.
1345 Old Cheney Road Lincoln, NE 68512
Conversion Planning
COURTESY AMOUNT READ (CAR) and
WINDOWS CHECK IMAGE PROCESSING
FORMS ORDERING WORKSHEET
Version 5.0
Database Release 19
( 2004 Information Technology, Inc. All rights reserved. Premier® is a registered trademark of Information Technology, Inc. (ITI). This material is proprietary to and published by Information Technology, Inc. (ITI) for the sole benefit of its clients. Reproduction, distribution, disclosure and use are expressly prohibited, except as authorized by license, or with the explicit written approval of ITI. The information contained herein is subject to change without notice. In no event will ITI be responsible for any direct, indirect, special, or consequential damages resulting from the use of this information. No warranties, either express or implied, are granted or extended by this document. Great care should be taken to ensure that any use of this information complies at all times with all applicable laws, rules and regulations.
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| |SPECIAL NOTICE TO “CAR” USERS | |
| | | |
| |If you have licensed the CAR module but will not be implementing CAR at the time of conversion, you may need to | |
| |order a supply of Standard Proof Documents (non CAR) to accommodate your immediate proof processing needs. These | |
| |forms can be ordered using the Forms Order Worksheets located on pages 7 - 16. | |
FORMS INTRODUCTION
Information Technology, Inc. can, as an additional service, provide forms for your computer system through our associated forms supply company. The following forms order worksheet will provide your institution with the information necessary to order the correct forms. Refer to the Pre-Printed Forms and Documents Brochure for samples of each form.
The Premier Director Check Imaging Processing Module (CIP) requires the use of Flex statement type LFS-201. The CIP statement and format have been designed to meet Postnet Barcode requirements and at the same time maximize the available space on the form. This design should reduce the number of pages required to print each statement, ultimately, saving both time and money.
|NOTE: |You may continue to utilize an ITI approved Flex statement form for all other types of statement production with the |
| |exception of DDA statements. |
Clients, who utilize the Premier Director Check Imaging Processing Module (CIP) as well as the Exception Item Module (EIM), need to order notice form LFN-601. These forms also meet Postnet Barcode requirements and allow the check image to be printed on the notice.
|NOTE: |You may continue to utilize an ITI approved Universal notice form for all other types of notification with the exception of |
| |EIM notices. |
The CIP forms utilize one of three non-standard envelopes: ENV-701, ENV-751 or ENV-801. Review the Image Envelope section of this order worksheet and determine if you prefer a single window envelope or a double window envelope. ENV-701 and ENV751 require statements and notices to be folded. For large volume customers, the ENV-801 envelope
(9” X 12-1/2”) is available which does not require statements to be folded.
Color selection is a part of the forms ordering process. The standard ink colors available are: red, green, blue, yellow, orange, brown and black. If you are using a special color, indicate the "PMS" number on the order form. If the "PMS" number is not known, enclose a sample of the form color to assist the forms company in matching colors. Statements used with imaging are preferably lighter in color and relatively clean, to provide the clearest images possible.
FORMS INTRODUCTION
When placing an order, we recommend ordering a different ink color for notices and statements. Since these forms are very similar in appearance, different colors will make it easier to distinguish them. All notice and statement paper will be white unless you request a specific color.
Should you elect to have your forms produced by another vendor, we ask that all communication with that vendor be through your institution.
Information Technology cannot accept any responsibility for forms produced in error by another vendor. It is strongly recommended the initial order of forms be produced through our forms supplier to ensure that accurate and correct forms will arrive at your institution prior to the installation of the CIP Module.
GENERAL FORMS ORDER INSTRUCTIONS
|1. |Review the sample forms located in the ITI Pre-Printed Forms and Documents Brochure. |
|2. |Please review the samples and select: |
| |Form style |
| |Ink color (paper color will be white unless you request a specific color) |
| |Font style for institution name and address (personalized option) |
| |Your logo, if desired (personalized option). |
| |Quantity of forms for initial order (we recommend a 6-12 month supply) |
|3. |Return the forms order at least 90 days prior to your anticipated conversion date. Mail the order to: |
| |Information Technology, Inc. |
| |Conversion Planning and Forms Department |
| |P.O. Box 22705 |
| |Lincoln, NE 68542-2705 |
|4. |Information Technology will review the forms order and place it with the forms supplier. |
|5. |Proofs will be sent to your institution for approval. Please review the proofs as quickly as possible and return them to: |
| |Office Systems, Inc. |
| |26 Hollenberg Court |
| |Bridgeton, MO 63044-2454 |
** FORMS WILL NOT BE PRINTED WITHOUT YOUR APPROVAL **
|6. |The forms will be shipped directly to your institution from the supplier's plant with an invoice for the forms and the freight. |
|7. |Standard re-order request forms may be obtained from Information Technology upon request. |
|8. |Retain pages 3 through 6 to use for forms ordering procedures. |
|9. |If you are ordering Standard Proof Documents (non “CAR”), photo copy and retain pages 7 through 16. Return originals to ITI. |
|10. |If you are ordering Check Imaging Forms, photocopy and retain pages 17 through 20. Return originals to ITI. |
|11. |If you are ordering “CAR” Proof Documents, photo copy and retain pages 21 through 30. Return originals to ITI. |
GENERAL FORMS ORDER INSTRUCTIONS
|12. |If you are ordering Item Entry Control Documents, photo copy and retain pages 31 through 32. Return originals to ITI. |
|13. |Photocopy and retain pages 33 through 36 for Standard Proof Document (non “CAR”) reorders. |
|14. |Photocopy and retain pages 37 through 38 for “CAR” Form reorders. |
|15. |Photocopy and retain pages 39 through 42 for “CAR” Proof Document reorders. |
|16. |Photocopy and retain pages 43 through 44 for Item Entry Control Document reorders. |
DEFINITIONS
"Personalized" forms are forms with a pre-printed institution name and address. Bank logo’s can also be embedded in the paper if desired.
"Non-Personalized" forms do not include a pre-printed institution name and address. The computer system will print the institution name and address on the form. Bank logo’s can also be embedded in the paper if desired.
Non-personalized forms are typically used in a multi-institution environment to relieve the computer operator of the task of changing forms for each institution.
"Laser" forms are 8 1/2" x 11" single sheet forms for use with laser printers. These forms are available as statements or notices. Each of the checking “Flex” statement formats is designed to also function as combined checking and savings statements for those institutions utilizing the combined statement feature.
As a checking statement, this form will allow a combination of features, such as a summary of related accounts, checking and savings transactions, check sequencing and demand deposit loan account information.
A "Statement Backer" is typically used only for checking or savings statements. However, the statement backer is universally designed to be used for checking, savings and/or certificate of deposit statements.
"Account Notices" are forms which are used for NSF notices produced by the Exception Item Module (EIM).
FORMS ORDER WORKSHEET
STANDARD PROOF DOCUMENTS (non “CAR”)
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|Institution Name: | |
| |(Please Print) |
|Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Telephone Number: |( ) - |Date: | / / |
| | | | |
|Fax Number: |( ) - | | |
SHIPPING INFORMATION: If forms are to be shipped to the same location as the above information, simply indicate “SAME”, otherwise complete the following shipping information with the appropriate street address.
|Institution Name: | |
| |(Please Print) |
|Street Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Billing Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Authorizing Agent: | |
| | |
|Authorizing Agent’s Title: | |
| | |
|Authorizing Agent’s Signature: | |
LOGO’S
Attach a copy of all of the logo’s you plan on using to this page. In order to expedite the forms ordering process, indicate the current font style used for each logo (i.e. Courier 10, Diploma, Times Roman, etc.).
| |
STANDARD PROOF DOCUMENTS (non “CAR”)
APPLICATION DEBIT AND CREDIT TICKETS FOR INTERNAL USE ONLY
|Form numbers: |COD-2501-NM, COD-2502-NM, COD-2515-NM, COD-2516-NM, |
| |DDA-2501-NM, DDA-2502-NM, DDL-2501-NM, DDL-2502-NM, |
| |LAS-2407-NM, LAS2408-NM, SAV-2501-NM, SAV-2502-NM, |
|(NM = Non MICR) |SAV-2515-NM, SAV-2516-NM, SDB-2401-NM, SDB-2502-NM |
| |1 Part form (standard trancodes) |minimum quantity | 1,000 |
| |1 Part form (custom trancodes) |minimum quantity | 2,000 |
|Form number: | | |E.G. DDA-2501-NM, SAV-2502-NM, etc. |
| |Standard ITI Transaction Code Form | |Quantity: | |
| |Non-Standard ITI Transaction Code Form | |Quantity: | |
1. Note: If using the non-standard ITI transaction code form, indicate what
transaction codes and associated descriptions should be used.
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Form number: | | |E.G. DDA-2501-NM, SAV-2502-NM, etc. |
| |Standard ITI Transaction Code Form | |Quantity: | |
| |Non-Standard ITI Transaction Code Form | |Quantity: | |
2. Note: If using the non-standard ITI transaction code form, indicate what
transaction codes and associated descriptions should be used.
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
STANDARD PROOF DOCUMENTS (non “CAR”)
APPLICATION DEBIT AND CREDIT TICKETS FOR INTERNAL USE ONLY
|Form number: | | |E.G. DDA-2501-NM, SAV-2502-NM, etc. |
| |Standard ITI Transaction Code Form | |Quantity: | |
| |Non-Standard ITI Transaction Code Form | |Quantity: | |
3. Note: If using the non-standard ITI transaction code form, indicate what
transaction codes and associated descriptions should be used.
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Form number: | | |E.G. DDA-2501-NM, SAV-2502-NM, etc. |
| |Standard ITI Transaction Code Form | |Quantity: | |
| |Non-Standard ITI Transaction Code Form | |Quantity: | |
4. Note: If using the non-standard ITI transaction code form, indicate what
transaction codes and associated descriptions should be used.
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
STANDARD PROOF DOCUMENTS (non “CAR”)
LOBBY FORMS - SAVINGS DEPOSIT AND WITHDRAWAL TICKETS
Form numbers: SAV-2503-NM & SAV-2504-NM
| |1 Part teller form | minimum quantity – non-personalized | 1,000 |
| |1 Part teller form | minimum quantity - personalized | 2,000 |
|Yes |No | |
| | |Personalized deposit and withdrawal forms? (If Yes, enclose print style for institution name) |
| | | |
| | |Should logo appear on deposit and withdrawal forms? (If Yes, enclose a sample logo) |
| | | |
| | |MICR encode a transaction code? (If Yes, indicate the savings deposit and withdrawal transaction codes) |
|Deposit |Withdrawal |
|Transaction Code: | | |Transaction Code: | |
| | | | | |
|Ink Color Required: | | |Ink Color Required: | |
| | | | | |
|Paper Color Required: | | |Paper Color Required: | |
| | | | | |
|Backer Required: | Yes No | | |
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|Quantity Required: | | |Quantity Required: | |
|Additional Information: | |
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STANDARD PROOF DOCUMENTS (non “CAR”)
GENERAL LEDGER DEBIT AND CREDIT TICKETS
Form numbers: GLA-2401-NM & GLA-2402-NM
| |1 Part form (blank) |minimum quantity | 1,000 |
| |1 Part form (custom) |minimum quantity | 2,000 |
NOTE: All GLA-2401-NM and GLA-2402-NM tickets will come standard with NO trancode
pre-printed.
If you are ordering standard general ledger debit and credit forms (no pre-printed account names or account numbers), indicate the quantity you wish to order below.
| |Form Number | |Quantity | |
| |GLA-2401-NM (Debit Forms) | | | |
| |GLA-2402-NM (Credit Forms) | | | |
If you are ordering general ledger debit and credit forms but wish to have account names and account numbers pre-printed (customized), indicate the general ledger account number, account name and quantity of each form below.
| | | | |Quantity Required |
|Debit |Credit |Account Number |Account Name | |
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STANDARD PROOF DOCUMENTS (non “CAR”)
GENERAL LEDGER DEBIT AND CREDIT TICKETS
Form numbers: GLA-2401-TCO-500 & GLA-2402-TCO-400
| |1 Part form (standard MICR trancodes) |minimum quantity | 1,000 |
| |1 Part form (custom) |minimum quantity | 2,000 |
NOTE: All GLA-2401-TCO-500 and GLA-TCO-400 tickets will come standard with the 500
or 400 trancode pre-printed.
If you are ordering standard general ledger debit and credit forms (no pre-printed account names or account numbers), indicate the quantity you wish to order below.
| |Form Number | |Quantity | |
| |GLA-2401-TCO-500 (Debit Forms) | | | |
| |GLA-2402-TCO-400 (Credit Forms) | | | |
If you are ordering general ledger debit and credit forms but wish to have account names and account numbers pre-printed (customized), indicate the general ledger account number, account name and quantity of each form below.
| | | | |Quantity Required |
|Debit |Credit |Account Number |Account Name | |
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STANDARD PROOF DOCUMENTS (non “CAR”)
CUSTOMER TRANSACTION RECEIPT FORM FOR USE WITH TELLER TERMINALS
Form numbers: TTM-400
| |1 Part teller form |minimum quantity | 5,000 |
For use with PW Teller, PLUS Teller, Premier Teller and Web Teller terminal
equipment.
|Yes |No | |
| | |Standard customer receipt verbiage? (refer to example in the Pre-Printed Forms and Documents Brochure) |
| | | |
| | |Non-standard customer receipt verbiage? (If Yes, enclose the information you want printed on the form) |
| | | |
| | |Personalized customer transaction receipt form? (If Yes, enclose print style for institution name) |
| | | |
| | |Should logo appear on customer transaction receipt form? (If Yes, enclose a sample logo) |
| | | |
| | |Should FDIC logo appear on form? |
| | | |
| | |Should Federally Insured logo appear on form? |
Please indicate the type of teller equipment being utilized:
| PW Teller | PLUS Teller | Premier Teller | Web Teller |
Please indicate the color required (E.G. white form with black print)
|Ink Color Required: | |Paper Color Required: | |
|Quantity Required: | | | |
STANDARD PROOF DOCUMENTS (non “CAR”)
TELLER CASH IN AND CASH OUT FORMS
Form numbers: TTM-402 & TTM-403
| |1 Part teller form |minimum quantity per teller | 5,000 |
| |2 Part teller form |minimum quantity per teller | 5,000 |
| | (non-carbon) | | |
|Account |Teller |Cash-In Trancode |Cash-Out Trancode |Quantity |Quantity |
|Number |Number | | |1-Part |2-Part |
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CHECK IMAGING FORMS ORDER WORKSHEET
| |
|Institution Name: | |
| |(Please Print) |
|Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Telephone Number: |( ) - | | |
| | | | |
|Fax Number |( ) - |Date | / / |
SHIPPING INFORMATION: If forms are to be shipped to the same location as the above information, simply indicate “SAME”, otherwise complete the following shipping information with the appropriate street address.
|Institution Name: | |
| |(Please Print) |
|Street Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Billing Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Authorizing Agent: | |
| | |
|Authorizing Agent’s Title: | |
| | |
|Authorizing Agent’s Signature: | |
Should the institution’s telephone number, fax number or web-site address, appear on the following forms?
| | | | | |Web-site |
| |Telephone # | |Fax # | |Address |
| |Yes |No | |Yes |No | |Yes |No |
|Checking Statements | | | | | | | | |
|Universal Notices | | | | | | | | |
|Telephone Number: | | |
|Fax Number: | | |
|Web-site Address: | | |
LOGO’S
Attach a copy of all of the logo’s you plan on using to this page. In order to expedite the forms ordering process, indicate the current font style used for each logo (i.e. Courier 10, Diploma, Times Roman, etc.).
| |
CHECK IMAGING FORMS
CHECKING STATEMENTS
| |minimum quantity – |1,000 (non-personalized) |2,000 (personalized) | |
The following statement forms are to be used if you utilize ITI's Premier image product (CIP). Existing supplies of ITI approved statements will suffice for all other types of statements (SAV, COD or LAS).
|Form Number |Form Description |
| |LFS-201-A* |“Laser Flex” Statement with Backer |
| |LFS-201-B* |“Laser Flex” Statement with Backer |
| |LFS-201-C* |“Laser Flex” Statement with Backer |
| |LFS-201-D* |“Laser Flex” Statement with Backer |
* Indicates Flex Statement Format 98 must be defined in the Demand Deposit Application’s Statement
Miscellaneous Specifications.
|Yes |No | |
| | |Personalized statement? (Enclose print style for institution name) |
| | |Should logo appear on statements? (Enclose a sample logo) |
| | |Should FDIC logo appear on statements? |
| | |Three-hole punched statement? (Recommended) |
| | |Use ITI standard backer? (If No, enclose a sample backer) |
| | |(If “Yes”: Backer #1 Backer #2 |
|Ink Color(s) Required: | |Quantity Required: | |
| | |(A 6-12 month supply is recommended) |
CHECK IMAGING FORMS
ACCOUNT NOTICES
| |minimum quantity – |1,000 (non-personalized) |2,000 (personalized) | |
Used for EIM notification with Premier Image.
|Form Number |Form Description |
| |LFN-601** |“Laser Flex” Notice |
|Yes |No | |
| | |Personalized notices? (Enclose print style for institution name) |
| | |Should logo appear on notices? (Enclose a sample logo) |
| | |Perforation required? |
|Ink Color(s) Required: | |Quantity Required: | |
| | |(A 6-12 month supply is recommended) |
** Indicates Flex Notice Form Type 5 or 6 must be defined in the Exception Item Processing Module Miscellaneous Specifications.
NOTE: Both Image Statements and Account Notices referenced above require ENV-701,
ENV-701-DW, ENV-751 or ENV-751-DW envelopes be used.
CHECK IMAGING FORMS
IMAGE ENVELOPES
| |minimum quantity |ENV-701 |5,000 |ENV-701-DW |1,000 |
| | |ENV-751 |1,000 |ENV-751-DW |1,000 |
| | |ENV-801 |1,000 | | |
| | | | | | |
The following envelopes are to be used if you utilize ITI’s Premier Image Product (CIP).
|Form Number |Form Description |
| |ENV-701 |Single Window |
| |ENV-701-DW |Double Window (For use with non-personalized forms) |
| |ENV-751 |6” x 9” for use with the Check Image Product. (One fold required) |
| |ENV-751-DW |6” x 9” Double Window (For use with non-personalized forms) |
| |ENV-801 |9” x 12-1/2” for use with Check Image Product. (Folding not required) |
|Yes |No | |
| | |Personalized envelope? (Enclose print style for institution name) |
| | |FDIC liner required? |
| | |Federally Insured liner required? |
| | |Linen liner required? |
| | |Logo watermark liner? (Enclose a sample logo) |
| | |Self-seal required? |
| | |Website Address? (If “Yes”, define address on page 15) |
| | | |
| | |Print “Service Requested” information below the Return Address Area? |
| | |(If Yes, indicate one of the following:) |
| | |Address Service Requested |Forwarding and return. New address notifications provided|
| | |Forwarding Service Requested |Forwarding and return. New address notification provided |
| | | |only for return. |
| | |Return Service Requested |No forwarding, only return. New address notification |
| | | |provided. |
| | |Change Service Requested |No forwarding or return. New address notification |
| | | |provided. |
|Return address and liner ink color: | |Quantity Required: | |
| | |(A 6-12 month supply is recommended). |
FORMS ORDER WORKSHEET
“CAR” PROOF DOCUMENTS
Information Technology, Inc., in conjunction with Office Systems, Inc., can also provide your institution with “Courtesy Amount Read” proof documents for your Windows imaging system. These documents consist of teller cash in and out tickets, debit and credit tickets for all applications, including general ledger, and savings deposit and withdrawal tickets.
| |Refer to the ITI Pre-Printed Forms and Documents Brochure for a complete description for each of the following proof documents. |
| |
|Institution Name: | |
| |(Please Print) |
|Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Telephone Number: |( ) - |Date: | / / |
| | | | |
|Fax Number: |( ) - | | |
SHIPPING INFORMATION: If forms are to be shipped to the same location as the above information, simply indicate “SAME”, otherwise complete the following shipping information with the appropriate street address.
|Institution Name: | |
| |(Please Print) |
|Street Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Billing Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Authorizing Agent: | |
| | |
|Authorizing Agent’s Title: | |
| | |
|Authorizing Agent’s Signature: | |
LOGO’S
Attach a copy of all of the logo’s you plan on using to this page. In order to expedite the forms ordering process, indicate the current font style used for each logo (i.e. Courier 10, Diploma, Times Roman, etc.).
| |
“CAR” PROOF DOCUMENTS
APPLICATION DEBIT AND CREDIT TICKETS FOR INTERNAL USE ONLY
|Form numbers |COD-2501, COD-2502, COD-2515, COD-2516, DDA-2501, DDA-2502, DDL-2501, DDL-2502, LAS-2407, LAS-2408, SAV-2501,|
| |SAV-2502, SAV-2515, SAV-2516, SDB-2401, SDB-2402 |
| |1 Part form (standard trancodes) |minimum quantity | 1,000 |
| |1 Part form (custom trancodes) |minimum quantity | 2,000 |
|Form number: | | |E.G. DDA-2501, SAV-2502, etc. |
| |Standard ITI Transaction Code Form | |Quantity: | |
| |Non-Standard ITI Transaction Code Form | |Quantity: | |
5. Note: If using the non-standard ITI transaction code form, indicate what
transaction codes and associated descriptions should be used.
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Form number: | | |E.G. DDA-2501, SAV-2502, etc. |
| |Standard ITI Transaction Code Form | |Quantity: | |
| |Non-Standard ITI Transaction Code Form | |Quantity: | |
6. Note: If using the non-standard ITI transaction code form, indicate what
transaction codes and associated descriptions should be used.
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
“CAR” PROOF DOCUMENTS
APPLICATION DEBIT AND CREDIT TICKETS FOR INTERNAL USE ONLY
|Form number: | | |E.G. DDA-2501, SAV-2502, etc. |
| |Standard ITI Transaction Code Form | |Quantity: | |
| |Non-Standard ITI Transaction Code Form | |Quantity: | |
7. Note: If using the non-standard ITI transaction code form, indicate what
transaction codes and associated descriptions should be used.
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Form number: | | |E.G. DDA-2501, SAV-2502, etc. |
| |Standard ITI Transaction Code Form | |Quantity: | |
| |Non-Standard ITI Transaction Code Form | |Quantity: | |
8. Note: If using the non-standard ITI transaction code form, indicate what
transaction codes and associated descriptions should be used.
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
|Transaction Code: | | |Description: | |
“CAR” PROOF DOCUMENTS
LOBBY FORMS - SAVINGS DEPOSIT AND WITHDRAWAL TICKETS
Form numbers: SAV-2503 & SAV-2504
| |1 Part teller form | minimum quantity – non-personalized | 1,000 |
| |1 Part teller form | minimum quantity - personalized | 2,000 |
|Yes |No | |
| | |Personalized deposit and withdrawal forms? (If Yes, enclose print style for institution name) |
| | | |
| | |Should logo appear on deposit and withdrawal forms? (If Yes, enclose a sample logo) |
| | | |
| | |MICR encode a transaction code? (If Yes, indicate the savings deposit and withdrawal transaction codes) |
|Deposit |Withdrawal |
|Transaction Code: | | |Transaction Code: | |
| | | | | |
|Color Required: | | |Color Required: | |
| | | | | |
|Backer Required: | Yes No | | |
| | | | | |
|Quantity Required: | | |Quantity Required: | |
|Additional Information: | |
| |
| |
| |
| |
| |
| |
| |
| |
“CAR” PROOF DOCUMENTS
GENERAL LEDGER DEBIT AND CREDIT TICKETS
Form numbers: GLA-2401-899 & GLA-2402-898
| |1 Part form (standard) |minimum quantity | 1,000 |
| |1 Part form (custom) |minimum quantity | 2,000 |
|NOTE: |All standard CAR general ledger debit forms will have T/C 899 and R/T Number 5610-0000 pre-encoded on each form. |
| | |
| |All standard CAR general ledger credit forms will have T/C 898 and R/T Number 5600-0000 pre-encoded on each form. |
If you are ordering standard CAR general ledger debit and credit forms (no pre-printed account names or account numbers), indicate the quantity you wish to order below.
| |Form Number | |Quantity | |
| |GLA-2401-899 (Debit Forms) | | | |
| |GLA-2402-898 (Credit Forms) | | | |
If you are ordering CAR general ledger debit and credit forms but wish to have account names and account numbers pre-printed (customized), indicate the general ledger account number, account name and quantity of each form below.
| | | | |Quantity |
|Debit |Credit |Account Number |Account Name |Required |
| | | | | |
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“CAR” PROOF DOCUMENTS
GENERAL LEDGER DEBIT AND CREDIT TICKETS
Form numbers: GLA-2401-500 & GLA-2402-400
| |1 Part form (standard) |minimum quantity | 1,000 |
| |1 Part form (custom) |minimum quantity | 2,000 |
|NOTE: |All standard CAR general ledger debit forms will have T/C 500 and R/T Number 5610-0000 pre-encoded on each form. |
| | |
| |All standard CAR general ledger credit forms will have T/C 400 and R/T Number 5600-0000 pre-encoded on each form. |
| | |
| |Each custom CAR general ledger debit or credit form you order with a unique T/C pre-encoded, must have a unique R/T number |
| |pre-encoded on each form as well. |
If you are ordering standard CAR general ledger debit and credit forms (no pre-printed account names or account numbers), indicate the quantity you wish to order below.
| |Form Number | |Quantity | |
| |GLA-2401-500 (Debit Forms) | | | |
| |GLA-2402-400 (Credit Forms) | | | |
If you are ordering CAR general ledger debit and credit forms but wish to have account names and account numbers pre-printed (customized), indicate the general ledger account number, account name, trancode, routing transit number and quantity of each form below. The first two are examples.
| | | | |Quantity |
|Debit |Credit |Account Number |Account Name |Required |
| | | | | |
|X | |15010001 |Federal Reserve Bank |5,000 |
| |Trancode: |501 |Routing Transit Number: |5610-0001 | |
| |X |21023001 |Treasury Tax & Loan |5,000 |
| |Trancode: |401 |Routing Transit Number: |5600-0001 | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
“CAR” PROOF DOCUMENTS
GENERAL LEDGER DEBIT AND CREDIT TICKETS
Form numbers: GLA-2401-500 & GLA-2402-400
| | | | |Quantity |
|Debit |Credit |Account Number |Account Name |Required |
| | | | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
| | | | | |
| |Trancode: | |Routing Transit Number: | | |
“CAR” PROOF DOCUMENTS
GENERAL LEDGER DEBIT AND CREDIT TICKETS
Form numbers: GLA-2401-TCO-500 & GLA-2402-TCO-400
| |1 Part form (standard) |minimum quantity | 1,000 |
| |1 Part form (custom) |minimum quantity | 2,000 |
NOTE: All GLA-2401-TCO-500 and GLA-TCO-400 tickets will come standard with the 500
or 400 trancode pre-printed.
If you are ordering standard CAR general ledger debit and credit forms (no pre-printed account names or account numbers), indicate the quantity you wish to order below.
| |Form Number | |Quantity | |
| |GLA-2401-TCO-500 (Debit Forms) | | | |
| |GLA-2402-TCO-400 (Credit Forms) | | | |
If you are ordering CAR general ledger debit and credit forms but wish to have account names and account numbers pre-printed (customized), indicate the general ledger account number, account name and quantity of each form below.
| | | | |Quantity |
|Debit |Credit |Account Number |Account Name |Required |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
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| | | | | |
| | | | | |
“CAR” PROOF DOCUMENTS
TELLER CASH IN AND CASH OUT FORMS
Form numbers: TTM-2402 & TTM-2403 (To be used if you Do Not utilize ITI’s Premier Teller Module
or if you validate on the back of the tickets)
TTM-2402A & TTM-2403A (To be used if you utilize ITI’s Premier Teller Module
or if you validate on the front of the tickets)
| |1 Part teller form: |minimum order per teller | 5,000 |
| |2 Part teller form: |minimum order per teller | 5,000 |
| | (non-carbon) | | |
| | |TTM-2402 & TTM-2403 | | |TTM-2402A & TTM-2403A |
|Account # |Teller |Cash-In |Cash-Out |Quantity |Quantity |
| |Number |Trancode |Trancode |1-Part |2-Part |
| | | | | | |
| | | | | | |
| | | | | | |
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FORMS ORDER WORKSHEET
ITEM ENTRY CONTROL DOCUMENTS
Information Technology, Inc., in conjunction with Office Systems, Inc., can also provide your institution with Item Entry Control Documents. The following control documents are required based on the type of proof capture device used. Locate the type of proof capture device you will be using, mark the box next to the form(s) you need to order and indicate the quantity for each.
| |Refer to the ITI Pre-Printed Forms and Documents Brochure for a complete description for each of the following control documents. |
|1. |Non-Image NDP Reader Sorter |
| |FORM | | | |
| |NUMBER |FORM DESCRIPTION | |QUANTITY |
| |IES-403 |Batch Tickets MICR encoded with 900 trancode, 1000 tickets | |
| | |per package | |
| |IES-411 |Pocket Bundle Tickets, 500 tickets per package | |
|If you currently use or have purchased the Bulk Filing Module, the following forms may be needed: | |
| |BFM-401 |Account Divider Tickets, 1,000 tickets per package | |
| |BFM-402 |Day Separator Tickets, complete set contains 100 tickets per | |
| | |day for 31 day month | |
| |IES-410 |End Pass Tickets, 250 tickets per package | |
FORMS ORDER WORKSHEET
ITEM ENTRY CONTROL DOCUMENTS
|2. |Image NDP Reader Sorter (No Power Encode) |
| |FORM | | | |
| |NUMBER |FORM DESCRIPTION | |QUANTITY |
| |IES-403 |Batch Tickets MICR encoded with 900 trancode, 1000 tickets | |
| | |per package | |
| |IES-404 |End Block Tickets, 100 tickets per package | |
| |IES-411 |Pocket Bundle Tickets, 500 tickets per package (Required | |
| | |only if your NDP has a secondary hopper) | |
|If you currently use or have purchased the Bulk Filing Module, the following forms may be needed: | |
| |BFM-401 |Account Divider Tickets, 1,000 tickets per package | |
| |BFM-402 |Day Separator Tickets, complete set contains 100 tickets per | |
| | |day for 31 day month | |
| |IES-410 |End Pass Tickets, 250 tickets per package | |
|3. |Image NDP1000/NDP1800 Reader Sorter (Power Encode/CAR) |
| |FORM | | | |
| |NUMBER |FORM DESCRIPTION | |QUANTITY |
| |IES-404 |End Block Tickets, 100 tickets per package | |
| |IES-411 |Pocket Bundle Tickets, 500 tickets per package (Required | |
| | |only if your NDP has a secondary hopper) | |
| |IES-432 |Power Encode Batch Tickets MICR encoded with 920 | |
| | |trancode, 1000 tickets per package | |
|If you currently use or have purchased the Bulk Filing Module, the following forms may be needed: | |
| |BFM-401 |Account Divider Tickets, 1,000 tickets per package | |
| |BFM-402 |Day Separator Tickets, complete set contains 100 tickets per | |
| | |day for 31 day month | |
| |IES-410 |End Pass Tickets, 250 tickets per package | |
STANDARD PROOF DOCUMENTS REORDER WORKSHEET
Detach and retain for proof documents reorder.
Office Systems, Inc. retains your original order specifications. If you are changing a form, please contact them or the ITI Conversion Planning & Forms Department.
| |Mail completed form to: | |Information Technology, Inc. |
| | | |Conversion Planning & Forms Department |
| | | |P. O. Box 22705 |
| | | |Lincoln, NE 68542-2705 |
| |OR | | |
| |Fax completed form to: | |Information Technology, Inc. |
| | | |Conversion Planning & Forms Department |
| | | |(402)421-4236 |
| |
|Institution Name: | |
| |(Please Print) |
|Billing Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Telephone Number: |( ) - |Date: | / / |
| | | | |
|Fax Number: |( ) - | | |
| | | | |
|Ordered by: | | | |
SHIPPING INFORMATION: If forms are to be shipped to the same location as the above information, simply indicate “SAME”, otherwise complete the following shipping information with the appropriate street address.
|Institution Name: | |
| |(Please Print) |
|Street Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Authorizing Agent: | |
| | |
|Authorizing Agent’s Title: | |
| | |
|Authorizing Agent’s Signature: | |
STANDARD PROOF DOCUMENTS (non “CAR”) REORDER WORKSHEET
| | |Form | |Quantity |
|PROOF DOCUMENT DESCRIPTION | |Number | |Required |
| | | | | |
|Certificate of Deposit Debit Transaction Forms | |COD-2501-NM | | |
| | | | | |
|Certificate of Deposit Credit Transaction Forms | |COD-2502-NM | | |
| | | | | |
|Certificate of Deposit IRA Debit Transaction Forms | |COD-2515-NM | | |
| | | | | |
|Certificate of Deposit IRA Credit Transaction Forms | |COD-2516-NM | | |
| | | | | |
|Demand Deposit Debit Transaction Forms | |DDA-2501-NM | | |
| | | | | |
|Demand Deposit Credit Transaction Forms | |DDA-2502-NM | | |
| | | | | |
|Demand Deposit Loan Debit Transaction Forms | |DDL-2501-NM | | |
| | | | | |
|Demand Deposit Loan Credit Transaction Forms | |DDL-2502-NM | | |
| | | | | |
|General Ledger Debit Transaction Form (blank) | |GLA-2401-NM | | |
| | | | | |
|General Ledger Credit Transaction Form (blank) | |GLA-2402-NM | | |
| | | | | |
|General Ledger Debit Transaction Form (500 T/C) | |GLA-2401-TCO-500 | | |
| | | | | |
|General Ledger Credit Transaction Form (400 T/C) | |GLA-2402-TCO-400 | | |
| | | | | |
|Loan Debit Transaction Forms | |LAS-2407-NM | | |
| | | | | |
|Loan Credit Transaction Forms | |LAS-2408-NM | | |
| | | | | |
|Savings Debit Transaction Forms | |SAV-2501-NM | | |
| | | | | |
|Savings Credit Transaction Forms | |SAV-2502-NM | | |
| | | | | |
|Savings IRA Debit Transaction Forms | |SAV-2515-NM | | |
| | | | | |
|Savings IRA Credit Transaction Forms | |SAV-2516-NM | | |
| | | | | |
|Safe Deposit Box Debit Transaction Forms | |SDB-2401-NM | | |
| | | | | |
|Safe Deposit Box Credit Transaction Form | |SDB-2402-NM | | |
| | | | | |
STANDARD PROOF DOCUMENTS (non “CAR”) REORDER WORKSHEET
| | |Form | |Quantity |
|PROOF DOCUMENT DESCRIPTION | |Number | |Required |
| | | | | |
|Savings Deposit Tickets | |SAV-2503-NM | | |
| | | | | |
|Savings Withdrawal Tickets | |SAV-2504-NM | | |
| | | | | |
|Customer Transaction Receipt Forms | |TTM-400 | | |
| | | | | |
|Teller Cash In Tickets | |TTM-402 | | |
| | | | | |
|Teller Cash Out Tickets | |TTM-403 | | |
| | | | | |
|Other _________________________________________ | | | | |
| | | | | |
Note: On all Proof Document reorders, please attach a photocopy of each form you are reordering, especially if you have any customized forms. If no photocopies are included with your reorder, the standard Proof Documents will be sent.
This Page Left Blank
“CAR” FORMS REORDER WORKSHEET
Detach and retain for forms reorder.
Office Systems, Inc. retains your original order specifications. If you are changing a form, please contact them or the ITI Conversion Planning & Forms Department.
| |Mail completed form to: | |Information Technology, Inc. |
| | | |Conversion Planning & Forms Department |
| | | |P. O. Box 22705 |
| | | |Lincoln, NE 68542-2705 |
| |OR | | |
| |Fax completed form to: | |Information Technology, Inc. |
| | | |Conversion Planning & Forms Department |
| | | |(402)421-4236 |
| |
|Institution Name: | |
| |(Please Print) |
|Billing Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Telephone Number: |( ) - |Date: | / / |
| | | | |
|Fax Number: |( ) - | | |
| | | | |
|Ordered by: | | | |
SHIPPING INFORMATION: If forms are to be shipped to the same location as the above information, simply indicate “SAME”, otherwise complete the following shipping information with the appropriate street address.
|Institution Name: | |
| |(Please Print) |
|Street Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Authorizing Agent: | |
| | |
|Authorizing Agent’s Title: | |
| | |
|Authorizing Agent’s Signature: | |
“CAR” FORMS REORDER WORKSHEET
| | |Form | |Quantity |
|FORM DESCRIPTION | |Number | |Required |
| | | | | |
|Demand Deposit Statements | | | | |
| | | | | |
|Account Notices | |LFN-601 | | |
| | | | | |
| | | | | |
|# 10 - Single Window Envelopes | |ENV-701 | | |
| | | | | |
|# 10 - Double Window Envelopes | |ENV-701-DW | | |
| | | | | |
|6” x 9” Single Window Envelopes | |ENV-751 | | |
| | | | | |
|6” x 9” Single Window Envelopes | |ENV-751-DW | | |
| | | | | |
|9” x 12-1/2” Single Window Envelopes | |ENV-801 | | |
| | | | | |
“CAR” PROOF DOCUMENTS REORDER WORKSHEET
Detach and retain for Windows “CAR” proof document reorders.
Office Systems, Inc. retains your original order specifications. If you are changing a form, please contact them or the ITI Conversion Planning & Forms Department.
| |Mail completed form to: | |Information Technology, Inc. |
| | | |Conversion Planning & Forms Department |
| | | |P. O. Box 22705 |
| | | |Lincoln, NE 68542-2705 |
| |OR | | |
| |Fax completed form to: | |Information Technology, Inc. |
| | | |Conversion Planning & Forms Department |
| | | |(402)421-4236 |
| |
|Institution Name: | |
| |(Please Print) |
|Billing Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Telephone Number: |( ) - |Date: | / / |
| | | | |
|Fax Number: |( ) - | | |
| | | | |
|Ordered by: | | | |
SHIPPING INFORMATION: If forms are to be shipped to the same location as the above information, simply indicate “SAME”, otherwise complete the following shipping information with the appropriate street address.
|Institution Name: | |
| |(Please Print) |
|Street Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Authorizing Agent: | |
| | |
|Authorizing Agent’s Title: | |
| | |
|Authorizing Agent’s Signature: | |
“CAR” PROOF DOCUMENTS REORDER WORKSHEET
| | |Form | |Quantity |
|DOCUMENT DESCRIPTION | |Number | |Required |
| | | | | |
| | | | | |
|Certificate of Deposit Debit Transaction Forms | |COD-2501 | | |
| | | | | |
|Certificate of Deposit Credit Transaction Forms | |COD-2502 | | |
| | | | | |
|Certificate of Deposit IRA DR Transaction Forms | |COD-2515 | | |
| | | | | |
|Certificate of Deposit IRA CR Transaction Forms | |COD-2516 | | |
| | | | | |
|Demand Deposit Debit Transaction Forms | |DDA-2501 | | |
| | | | | |
|Demand Deposit Credit Transaction Forms | |DDA-2502 | | |
| | | | | |
|Demand Deposit Loan Debit Transaction Forms | |DDL-2501 | | |
| | | | | |
|Demand Deposit Loan Credit Transaction Forms | |DDL-2502 | | |
| | | | | |
|General Ledger Debit Transaction Forms | |GLA-2401-899 | | |
| | | | | |
|General Ledger Credit Transaction Forms | |GLA-2402-898 | | |
| | | | | |
|General Ledger Debit Transaction Forms (500 T/C) | |GLA-2401-500 | | |
| | | | | |
|General Ledger Credit Transaction Forms (400 T/C) | |GLA-2402-400 | | |
| | | | | |
|General Ledger Debit Transaction Forms (500 T/C Only) | |GLA-2401-TCO-500 | | |
| | | | | |
|General Ledger Credit Transaction Forms (400 T/C Only) | |GLA-2402-TCO-400 | | |
| | | | | |
|Loan Debit Transaction Forms | |LAS-2407 | | |
| | | | | |
|Loan Credit Transaction Forms | |LAS-2408 | | |
| | | | | |
|Savings IRA Debit Transaction Forms | |SAV-2515 | | |
| | | | | |
|Savings IRA Credit Transaction Forms | |SAV-2516 | | |
| | | | | |
|Safe Deposit Box Debit Transaction Forms | |SDB-2401 | | |
| | | | | |
|Safe Deposit Box Credit Transaction Forms | |SDB-2402 | | |
| | | | | |
“CAR” PROOF DOCUMENTS REORDER WORKSHEET
| | |Form | |Quantity |
|DOCUMENT DESCRIPTION | |Number | |Required |
| | | | | |
|Savings Debit Transaction Forms | |SAV-2501 | | |
| | | | | |
|Savings Credit Transaction Forms | |SAV-2502 | | |
| | | | | |
|Teller Cash In Tickets | |TTM-2402 | | |
| | | | | |
|Teller Cash Out Tickets | |TTM-2403 | | |
| | | | | |
|Teller Cash In Tickets | |TTM-2402A | | |
| | | | | |
|Teller Cash Out Tickets | |TTM-2403A | | |
| | | | | |
|Other __________________________________________ | | | | |
Note: On all CAR Proof Document reorders, please attach a photocopy of each form you are reordering, especially if you have any customized forms. If no photocopies are included with your reorder, the standard CAR Proof Documents will be sent.
This Page Left Blank
ITEM ENTRY CONTROL DOCUMENT REORDER WORKSHEET
Detach and retain for forms reorder.
Office Systems, Inc. retains your original order specifications. If you are changing a form, please contact them or the ITI Conversion Planning & Forms Department.
| |Mail completed form to: | |Information Technology, Inc. |
| | | |Conversion Planning & Forms Department |
| | | |P. O. Box 22705 |
| | | |Lincoln, NE 68542-2705 |
| |OR | | |
| |Fax completed form to: | |Information Technology, Inc. |
| | | |Conversion Planning & Forms Department |
| | | |(402)421-4236 |
| |
|Institution Name: | |
| |(Please Print) |
|Billing Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Telephone Number: |( ) - |Date: | / / |
| | | | |
|Fax Number: |( ) - | | |
| | | | |
|Ordered by: | | | |
SHIPPING INFORMATION: If forms are to be shipped to the same location as the above information, simply indicate “SAME”, otherwise complete the following shipping information with the appropriate street address.
|Institution Name: | |
| |(Please Print) |
|Street Address: | |
| |(Please Print) |
|City, State, Zip Code: | |
| |(Please Print) |
|Authorizing Agent: | |
| | |
|Authorizing Agent’s Title: | |
| | |
|Authorizing Agent’s Signature: | |
ITEM ENTRY CONTROL DUCUMENTS REORDER WORKSHEET
| | |Form | |Quantity |
|ITEM ENTRY DOCUMENT DESCRIPTION | |Number | |Required |
| | | | | |
|Proof Block Balance Sheets | |IES-401 | | |
| | | | | |
|Start Block Tickets | |IES-402 | | |
| | | | | |
|Batch Tickets MICR encoded (900 T/C) | |IES-403 | | |
| | | | | |
|End Block Tickets | |IES-404 | | |
| | | | | |
|Trace Number Tickets | |IES-405 | | |
| | | | | |
|Batch Balancing Tickets | |IES-407 | | |
| | | | | |
|Batch Subtotal Tickets | |IES-408 | | |
| | | | | |
|End Pass Tickets | |IES-410 | | |
| | | | | |
|Pocket Bundle Tickets | |IES-411 | | |
| | | | | |
|Batch Tickets MICR encoded (2222-2222 R/T) | | | | |
|(Unisys track software proof machines only) | |IES-412 | | |
| | | | | |
|Block Extension Ticket | |IES-413 | | |
| | | | | |
|Sequential Block Ticket | |IES-415 | | |
| | | | | |
|Batch Tickets MICR encoded (2222-2222 R/T) | | | | |
|(Unisys track software DP500 Check Image | | | | |
|Power Encode users only) | |IES-422 | | |
| | | | | |
|Batch Ticket MICR encoded (920 T/C) | | | | |
|(DPS (windows) track software Check Image | | | | |
|Power Encode users only) | |IES-432 | | |
| | | | | |
| | | | | |
|Account Divider Tickets (998 T/C) | | | | |
|(B9190, DPM and DPS (windows) track software | | | | |
|only) | |BFM-401 | | |
| | | | | |
|Day Separators | |BFM-402 | | |
| | | | | |
|Account Divider Ticket (Blank) | | | | |
|Unisys track software only) | |BFM-403 | | |
| | | | | |
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