Required Agency Information

Please fill the required information in, print this sheet off and fax to the State Treasurer’s Office at 402-471-0816 along with a copy of the current deposit ticket used by each agency location.

Agency Name

Agency #

Agency location

Agency location code if already assigned

Contact name

Contact phone number

Contact email address

Shipping address ( Cannot ship to Post Office Boxes )

Payment Process (Required)

Please provide an expense business unit with object code .521500 per location code so we can create a payment to Deluxe Small Business Services.

Treasury Management Staff or State Accounting staff will create a voucher or JE to charge agency for reorder of tickets as orders are transitioned to Deluxe. Deluxe will bill TM. Each location needs to fax a copy of the current deposit ticket to our office.

Reorders

Each agency will email tmstaff@treasurer.org when they need to reorder. Please provide agency name, location code, quantity requested, name & phone number of agency location.

Prices

200 $24.60

400 $27.30

600 $30.00

800 $34.50

These prices are for 3-ply tickets. These prices do not include shipping. They are fixed prices for the next two years.