| Brand | TOPS? |
| Brand Contact | 800-282-7261 |
| Can Ship via Air Carrier?, Can Ship via UPS? | Yes |
| Carton Pack Dimensions, Item Dimensions | 10.13 in. x 12.50 in. x 11.63 in. (W x H x D) |
| Carton Pack Quantity | 1500 ST |
| Carton Pack Weight, Item Weight | 31.000 lbs |
| Considered Green (less environmental impact)?, Hazmat restrictions?, Is Certified with EPA/CPG?, Made of Some or All Recycled Materials?, Underwriter's Laboratory Approval?, Warranty Offered? | No |
| Copy Types | Two-Part Carbonless |
| Country of Origin | US |
| Footnote 1 | Carbonless Duplicate |
| Form Quantity | 1500 |
| Form Size | 8 1/2 x 11 |
| Forms Per Page | 1 |
| Global Product Type | Forms-Insurance |
| Layout | One Form per Sheet |
| Manufacturer Stock No. | 50124RV |
| Meets ANSI/BIFMA?, Retail UPC | 025932512407 |
| Office Depot Equivalent SKU | 561593 |
| Office Max Equivalent SKU | 21297482 |
| Paper Color(s) | White |
| Paper Stock | 20-lb. |
| Post-Consumer Recycled Content Percent, Pre-Consumer Recycled Content Percent, Total Recycled Content Percent | 0% |
| Principal Heading(s) | 1500 Health Insurance Claim Form |
| Print and Ruling Color(s) | OCR Red |
| Printer Compatibility | Dot Matrix |
| Product ID | 9472549 |
| Punching | Dot Matrix Pin Feed Holes |
| Special Features | Carbonless Duplicate-Continuous Form. |
| Staples Equivalent SKU | 2408491 |
| Unit of Measure | CT |
| UNSPSC Number | 00141118 |
| Warranty Offered? | n |
