The following worksheet is designed to assist you
with the many decisions and options available
during your implementation of Check 21.

You can enroll now for our Program, or simply request pricing.
An itemized budget with recommended quantities, and options,will be provided at no charge.

To receive our FREE Check 21 preliminary staff education presentation,
please call 308-381-0311 or email request to check21@bankall.com

Check 21 - Worksheet & Enrollment

YES! Sign us up for the Check 21 Customer Awareness & Education Program $500 program fee will be included in your budget proposal. Please provide us with detailed pricing prior to enrolling for your Program - no charge.

Bank: Name: Title: Address: City: Phone: Email: Website: Skip to end

Optional # Checking accounts (retail): # Checking accounts (commercial): # Savings accounts (include Money Market, Passbook, etc.): # of Branches: # of Employees (approx.): Do you have any affiliated banks operating under a different name/logo? Yes No If yes, how many different bank names/logos are included in this pricing: The following decisions will affect the information your customers need to know. Is your bank on a check imaging system? Yes No ...............................Imaging provider: If not, are you planning to install check imaging this year? Yes No Not Sure Types of statements your bank currently delivers (check all that apply): Return Original Checks Image Statements Truncated Safekeeping Email Statements CD-ROM Statements Other: Do you plan to make significant changes to your statement options this year? Yes No Not Sure Please describe: Are you currently participating in an Image Exchange program? Yes No Not Sure If not, are you planning to participate in Image Exchange within the next year? Yes No Not Sure Image Statements only: How will substitute checks be handled? Image of check only portion will be intersorted with all other checks. Image of the full substitute check will be sorted separatly at the end of the statement. Other: All returned items: How will substitute checks be handled in your items. (check all that apply) Original substitute checks returned. Image of full substitute check returned. Image of the check only portion of substitute check. Substitute checks not included with returned items. Would you like to receive our FREE Check 21 Staff Training Presentation? Yes No Would you like to receive information on Beavercreek's marketing program for check imaging? Yes No Back to top Please allow 2-3 business days for detailed pricing.