EXPRESS CHECK ORDER FORM First State Bank of Bloomington (309) 662-0411
Order the checks I ordered last time.
Special Instructions - Indicate any changes you would like in your order in the box below:
Order a different selection than what I ordered last time.
160 Duplicate-style Checks [Blue Safety, Yellow Safety, Blue Marble & Bank] - $4.00 ($8.50 if mailed) [Antique, Green on Stone, Clouds, Green Granite, Sunflowers, Sports & Lighthouses] - $6.00 ($10.50 if mailed)
Number of Boxes:
100 Wallet-style Deposit Slips - $5.00 (PICKUP ONLY)
200 Wallet-style Deposit Slips - $10.00 ($14.50 if mailed to you)
I will pick up my order in the Bank Lobby.
I will pick up my order at the Drive-Thru.
Please mail my order to me.
Address Printed on Checks:
* Name:
* Daytime Phone Number:
* Email Address:
Additional Comments:
Order Checks Push-Button Banking Report Lost/Stolen Card Fraud Forms and Disclosures FDIC's Transaction Account Guarantee Program Contact Us
