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INVOICE NUMBER DATE DESCRIPTION AMOUNT DISCOUNT NET AMOUNT

CHECK AMOUNT

CHECK NO.

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THIS DOCUMENT MUST HAVE A COLORED BACKGROUND, ULTRAVIOLET FIBERS AND AN ARTIFICIAL WATERMARK ON THE BACK - VERIFY FOR AUTHENTICITY.

Item # F935 To reorder, please call Blackbaud Forms at our toll free number, 866.422.3676

PAY

TO THEORDEROF

CHECK DATE

AUTHORIZED SIGNATUREORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINAL

TEXT OVER SIG LINE

YOUR FINANCIAL INSTITUTION123 MAIN STREET

ANYTOWN, USA 12345

00-000/0000

000000000123 456 789001001

FRIENDS OF THE CITY CENTER LIBRARY

FRIENDS OF THE CITY CENTER LIBRARY

123 MAIN STREETANYTOWN, USA 12345

555.123.4567 • FAX 555.123.5678

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