This document is a sample check with fields for the payee's name, amount in dollars, date, and lines for a memo. It includes the issuing bank's name, address, and check number in the upper left corner along with routing and account numbers at the bottom.

1. Name _____________________________ Date ___________________
Checks
101
DATE______________________
PAY TO THE
ORDER OF _____________________________________________ $ ______________
_______________________________________________________________ DOLLARS
MoneyInstructor.com Bank
1221 Main Street
Anywhere, US 10001
FOR ____________________________ _______________________________
74894934 6793868122 0101
www.MoneyInstructor.com